Your Name (required)

Address (required)

Phone (required)

Your Email (required)

Dog information:

Dog's Name / Age / Breed (required):

Is your dog on any medications or have any pre-existing medical conditions?

How was the dog acquired?

BreederPet ShopShelter/Welfare OrgPoundStray

How old was the dog when brought home?

Please list the problems in order of severity:

How would the owner rate the intensity of the problem?

Under what circumstances does the behavior occur? Has the behavior recently changed? Any explanation to why?

Has anything been tried so far to correct, improve or manage the problem? If the dog was acquired as an adult, why was the dog re-homed?

Obedience Status

On a scale of 1 to 10 with 10 being excellent and 1 being poor, describe your dogs ability to:

Sit:

Drop:

Stay:

Recall:

Loose Lead Walk:

Home Environment

UnitTown HouseHouse with small yardHouse with large yardAcerage

Describe the dog exercise routine:

Where does the dog sleep at night?

What do you feed your dog & how many times per day?

What is your dogs reaction when you leave & when you get home?

What age was the dog when it began training & who was involved?

Other

What are the owners expectations from the training sessions?

How much time do you / friends / family have available to work and train your dog?

Any other comments or helpful information?

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