Client's Name * Client Email * Client Phone * Alternate Contact Name Alternate Contact Phone Dog's Name * Breed / Mix * Date of Birth / Age * How did you hear about us? * Who referred you? If you found us through a method not listed above, please enter it here. If spayed/neutered, at what age? * How long have you had your dog? * Were there previous owners? * Age of dog when adopted/purchased? How long has this dog been in your care? Where did you obtain your dog? * Where did you obtain your dog? (other) * Name of breeder/shelter. Did the shelter have any information about the dog's life previous to your adoption? Does your dog have any particular way they like to be petted? * Why did you get your dog? Please check all that apply: * Do we have permission to post photos or videos of your puppy/dog on social media? We often do as a way to show you progress and to show off your beautiful baby! * MEDICAL Veterinarian's Name * Month / Year of last vet visit * Month / Year of last vaccination * Vaccine(s) given * Current health problems and/or medications Does your dog have any allergies, including food allergies? Is your dog easily handled by the vet staff? * Has your dog ever had to be muzzled? * Is your dog on heartworm preventative? * Heartworm Preventative Brand * Heartworm Preventative Last Received * Is your dog on flea and/ or tick preventative? * Flea/Tick Preventative Brand * Flea/Tick Preventative Last Received * May we contact and discuss health and behavioral issues with your veterinarian? * If yes, please initial here: * DIET AND ELIMINATION What type of food do you feed? (e.g., raw, dry kibble, canned) * How often? * How much? * At approximately what times? * Approximately how long has your dog been on this food? * Does your dog finish all food at meals? * If not, how long is the food left down? * If your dog does not finish meals is this a normal or unusual occurrence? * If this is unusual, how long has it been going on? * Does your dog receive treats? * Frequency and type of snacks. * Please list 3 of your dog’s favorite foods/treats: * Has your dog ever become possessive of his food or a treat? * If yes, please describe in as much detail as possible: Is your dog reliably housetrained? * Is your dog crate trained? * If Paper/Pad trained, where in the home do you usually place the pads ? * Do you have a dog door? * If not, how many times daily do you let your dog out (or take them on walks) to eliminate when you are at home? * Average Walk Time * Average elimination time * Average number of eliminations per walk * EXERCISE What type of exercise does your dog get? * How long does the exercise last/how often is it provided? (For example, “a 15-minute walk three times daily,” or “plays with the neighbor's dog for an hour once a week.”) * What kind of toys does your dog enjoy playing with/Do they have a favorite? * Does your dog have any favorite games they like to play? * Who is normally responsible for exercising your dog? * If walks are provided, what type of collar and leash is being used? (Collar examples: “regular buckle collar,” “head halter,” “body harness,” “pinch/prong collar,” “choke chain.” Leash examples: “6-foot nylon leash,” “retractable leash.”) * Does your dog get easily distracted or pull you on walks? * Does your dog ever become reactive toward other dogs or people on walks? * If yes, please describe: * Is your dog friendly with dogs they do not know? * Is your dog friendly with strangers? * List all people, including yourself, who live in your household: (Name, Gender, Age (of children), Relationship to you) * Do any friends/ neighbors/ family/ children from outside the family frequent the home? * Does your dog “belong to” a particular household member (e.g., son) or everyone? * Who will be responsible for practicing training exercises with the dog? * Do any household members dislike the dog, and if so, why? * Are any household members frightened of the dog, and if so, why? * Is the dog frightened of any household members, and if so, why? * Where is your dog kept when you are not at home? * Indoors not confined In yard not confined In yard tied out or chained Indoors confined In yard confined to dog run Other If you selected "other", please describe here: * If indoors, is your dog ever confined (crated, penned) while you are home? * If so, how long is your dog confined during the day? * Where does your dog sleep at night? * If you selected "other", please where your dog sleeps. * How many hours during the day is your pet without human companionship? * Three things I like about my dog: * Three things I do not like about my dog: * Do you have other pets? * Please describe the type/ age/ sex of your other pets and whether they have been fixed or not. TRAINING What type of training have you already tried? (check all that apply) * If group class, did you complete the course? * Training methods used (check all that apply): List organization name and/or trainer’s name(s): * How much time do you plan to dedicate for your dog's training? * For each behavior below, estimate what percentage of the time he will do so when asked: Sit * Down * Stay * Walk nicely on leash * Leave it * Give * Wait * Go to your place * Quiet * Off (furniture or when jumps up) * Others behaviors (including tricks): Check the behaviors that apply to your dog: * Notes / additional descriptions from the above behavior list: List any procedures/training equipment you’ve used to try to correct the behaviors checked above: What would you like help with, in order of importance? * Has your dog ever bitten anyone? * Has your dog ever bitten another animal? * If your dog has bitten anyone or another animal, please describe in as much detail as possible: * Has medical attention been necessary (for humans or animals) because of any aggressive incident? * If medical attention has been necessary, please explain: * What is your dog’s usual reaction when a person they have not met before enters the home? * When was the last time a person unfamiliar to your dog entered the home? * Is there anything else you feel it would be important for us to know?