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Questionnaire for the DOG's guardian before the live consultation
Before the consultation, please fill in the data below, which is necessary to start the diagnosis and prepare a treatment plan and additional materials for our meeting. Thanks to this, it will be easier to plan the best consultation form and the time we might need for our meeting. Knowing the problem in more detail, I might ask you to prepare some videos or perform a veterinary check-up before the consultation. Filling in all the information below now will allow us not to waste any precious time of the meeting itself on formalities and setting up a client card. We can focus 100% on improving the comfort of your dog and you.

NOTE -  If you have several dogs, of course. In each of the questions below, tell us about each of them. Even if the question, for simplicity, is in the form of a question about only one dog. Thank you!
Email *
Your name and surname (include preferred pronouns):
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What is your dog's name? 

If there are several dogs in the house, please write a short description of each of them so that I can recognize them in the video, e.g. black - name X, beige Labrador-type with white socks - name Y
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Dog's age:
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Dog's gender: *
Required
Is your dog neutered/spayed? And if so, at what age was the procedure performed?
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What is the breed/breed type of your dog?
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At what age was your dog adopted by you (you lived together)?
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What is your dog's origin? A breeder, shelter, rescue...? What was his/her history before (s)he came to you, if you know anything about it?
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Does your dog currently suffer from any illnesses/diseases/allergies? Has (s)he had any illnesses/surgeries in the past? Does (s)he take any medications/supplements?
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Your dog's weight (in kg)
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Choose what type of problematic behaviour you are struggling with your pet:
 *
Required
Describe in your own words the problem you are reporting - what behaviors are bothering you, since when did the problem occur, with what intensity, how have you tried to deal with it so far:
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On a scale of 1 to 10, how do you rate the strength of the problem at the moment: *
Minor
Hard to bear
How will you describe your dog briefly? Does your observation show that it is, for example, fearful, very active, aggressive, withdrawn ... Or maybe the behavior has changed recently, then write what has changed? *
What is your dog's diet? What brands and kinds of food do you use - wet, dry, or homemade? Are the bowls available at all times or only during meals? How many meals a day does your dog have? Do you serve meals in bowls or some other way?
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What is your dog's daily routine? Include repetitive routine behaviours from morning to evening, e.g. wake up around 7.00, meal around 7.30, walk 30 minutes, the dog stays home alone for about 5 hours ...., playing with the ball with guardians 15 minutes around 6:00 p.m. 19...etc. Also, be sure to write if there has been any change in this pattern recently, e.g. a new household member has appeared, you have changed your working hours ... Be sure also to include the duration of all walks and possible routes, e.g. around the block, park, dog park, forest etc.
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Are there any other animals in the house, and if so, what kind (species, age, gender)? If you have several animals at home, describe the relationships between them.
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How many household members are there in the house? Write their names. Here you can also add your preferred pronouns.

Are there children at home? If yes, please also specify their age.
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What toys and activities does your dog like the most?
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Does your dog wear a collar or a harness (what type?)? What type and length of leash do you usually use?
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Does your dog destroy his/her toys? If so, what type of toys and to what extent? 

For example, does (s)he, take the plush out of stuffed toys, can (s)he chew hard plastic toys or rubber balls? Does (s)he ever swallow and eat fur/pieces of toys/filling of the toys, or even if (s)he tears them apart, (s)he spits them out right away and leaves the rest?
 *

How does the dog react to visitors? Has it had any aggressive behaviour/bites on his/her account (on you or strangers)? 

If an attack took place, additionally please answer the following questions: 

1. What was the situation when a bite has happened? 

2. Was it a scratch or a bite? 

3. Was the wound stabbed or lacerated? 

4. Was a surgical intervention necessary? 

5. Is the dog used to a muzzle?

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How do you know about the Pet on the couch?
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If you are here by recommendation, please write from whom ;-)
Please provide your full home address, including the postal code, which I need for invoice purposes.

Also, please write down here the exact address/place of our consultation, including all the helpful information on how to find your spot, for example, the location of the staircase, floor number, parking opportunities nearby, etc. (I really care about punctuality, so I don't want to get lost;-))
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Preferred date for online consultation (remember to reserve approximately 2 hours for our meeting). Select all the options that suit you or suggest 2-3 concrete dates in the (Other answer) option, which I will try to match.
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Required
I have read the Terms of Service, the Privacy and Cookies policy, and I agree with their terms. (Required) 
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Required
Upload here
(1) a picture of your dog(s) 
and 
(2) the most recent veterinary lab reports you have (blood test, urinary test, stool test). 

Please choose the photo you like the most because it will appear on the cover of your post-consultation report and in the album of my clients on the website. 

When it comes to a group of animals, it's best to name the photo after the animal in it; this will allow me to get to know your pets and match them to the descriptions more easily.
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Add file
Required
If you have any additional comments/questions that I should address during the consultation, feel free to write here:
Prepare VIDEOS of your dog(s) in action ;-) 

Remember to send it to me by e-mail to the address petonthecouch@gmail.com for min. 3 DAYS BEFORE our consultation. You can use Google Drive or Wetranfer for bigger attachments. This is a necessary condition to start the consultation!
If you report the problem of conflict in the herd, try to record these conflict situations. If the problem is intense barking, record those situations, so that the dog's behaviour, context and surroundings are visible. Remember to behave as you usually do in such a situation - the point is to have the best possible picture of what exactly is happening.

Depending on the problem, I will be glad to suggest to you, more precisely, by e-mail, what videos might be needed in your case- feel free to ask for more details.
A copy of your responses will be emailed to the address you provided.
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