PART I: Owners Information
Brand of Dog Food
How many adults live at home with the dog?
How many children live at home with the dog? What ages?
PART II: Dogs Information
Is your dog neutered or spayed?
Veterinarian Name & Phone Number
Type of Heart worm Prevention
Day of Month HW Prevention administered
Type of Flea/Tick Prevention
Day of Month F/T Prevention administered
Is your dog on any other medication? If yes, please detail.
Dogs Emergency Contact Name
Dogs Emergency Contact Phone Number
Do other pets live in the home? If yes, please detail.
Does your dog interact well with other animals?
Is your yard fenced?
I dont have a yard
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List is empty.
Do you have an 'Invisible Fence' system?
Does your dog tolerate being crated?
Is there anything you would like me to know about your dog’s present reaction to being crated?
Mark any of the problems you may be having with your dog
Pulls on leash
Does not come when called
Jumps on people
Urinates when excited or afraid
Mounts people or objects
Aggressive towards dogs
Aggressive towards people
Guards toys, food, or objects
Nuisance barking / whining
Bolts through open doors
Overactive and doesn't settle down easily
Sniffs or eats off countertops and tables
Jumps on furniture
Digs in yard
Growls at Family Members When:
Chews Destructively on:
Anything Else You Would Like to Share About Your Dog?
What are the most important things I can teach your dog to help you enjoy your pet to the fullest?
How did you find/hear about us? Please be specific, i.e. search terms, etc.