Guardian's Name
*
First Name
Last Name
Dog's Name
Where did you get your dog from?
Include any additional information you know about your dog's previous life i.e.: adopted from a rescue, lived in and did well in a foster home for 2 months, originally found as a stray. Or if from a breeder, provide breeder information.
Does your dog have any health conditions?
If yes, please provide any details you have
Date of last veterinary exam
Approximate is fine
MM
DD
YYYY
How would you describe your dog's appetite
Check all that apply
Will eat virtually anything
Refuses all but high value food when outside/when distractions or triggers are present
Skips meals regularly
Eats meals consistently
Takes treats sometimes but not consistently
Takes treats in the house but won't eat outside
Physical Health
Check all that apply
Occasional limping/stiffness
Excessive itching/licking
Diarrhea or vomitting 1x/month or more
Aggressive reaction when touched
Aggressive with grooming or veterinary exams
Suspected/confirmed dental issues (i.e. refuses hard treats or food, chews only with one side of their mouth or with other strange chewing behavior, chronic bad breath in young dogs, etc.)
Unusual movement when running, walking or trotting
Mental Health
Check all that apply
Chases shadows or lights
Random aggressive outburts
General confusion (overall or at certain times of day)
Inability to settle
Sleeping less than 6 hours a day (not including overnight)
Pacing in the home or yard
Excessive whining
Tail chasing
Other compulsive/stereotypic behavior (self injuring, excessive licking of furniture/walls/etc., or any other behavior that seems excessive and hard for your dog to control in themselves)
What is your main reason for pursuing training?
I.e. barking and lunging on leash, fighting with other dog in the home or just looking for puppy raising support
Has your dog ever bitten a person or other animal and broken the skin?
Not including during play
Yes
No
Has your dog ever bitten another dog or domestic animal and broken the skin?
Including during play
Yes
No
When playing, does your dog get over-excited and struggle to calm down?
With humans or other dogs. May include behaviors like incessent play biting, mounting, barking, body slamming; without stopping when asked or when the playmate is clearly trying to get away or stop play.
Yes
No
Which best describes your training concerns
Select all that apply
Aggression towards strangers (human)
Aggression towards other dogs (outside of the household)
Aggression towards other dog(s) in the household
Aggression towards cats or other domesticated animals in the home
Basic training (pulling on leash, door dashing, jumping up, etc.)
Puppy basics
Confidence/fearfulness
Handling sensitivity (including fear or aggression when handled)
Resource guarding
Community skills (patio manners, visiting pet friendly stores, etc.)
Off leash skills
Multi-dog household management
Other, expand in following section
Have you worked with another trainer in the past?
In person or virtually
Yes
No
If applicable, describe your experience with trainers/training in the past
Can include self study or working with a professional
Basic Training
Check all that you'd like included in your training plan
Loose leash walking
Heeling
Off leash skills
"Place" / station
Leave it
Default down / auto settle
Patio manners
Other (expand in text box)
Other:
Behavior Goals
Check all that apply
Build confidence
Neutral around other dogs/people on walks
Have visitors come over
Play with other dogs
Expand social circle with humans
Other (expand in text box)
Other:
Which learning materials help you the most?
Check all that apply
Demonstration videos
Written instructions
Worksheets
Structured assignments
Describe your living situation
Check all that apply
House
Apartment
Townhome/duplex
No yard
Yard, not fenced
Yard, fenced
Shared yard
Live alone
Live with family
Live with roomates
Residential area
Busy city area
Rural area
Describe your activity level when it comes to training/time with your dog
Be honest! No judgement here. This just helps me create an achievable plan.
I have very limited time to train and need to work it in to my day to day life
I have some time to set aside for training
I have a lot of time to set aside for training
I'm physically active and able to handle my dog on a leash
I have limited ability to be physically active and/or I struggle to control my dog on leash
I am able to hike/walk with my dog daily
I am able to hike/walk with my dog on weekends
I am unable to hike/walk with my dog
Resources
These are some examples of things we'd use in a training plan. Check all that you have or can gain access to.
Dog friendly transportation
Safe off leash space
Cameras to monitor dog's behavior
Finances to invest in dog supplies
Friends/family to assist
Safe dogs to assist
Finally, is there anything else you'd like to share?
You can also include any questions you may have here.
Email
*