Online Assessment
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Owner's Name *
Phone Number *
Email Address *
How would you like to be contacted? *
Where are you located?
How did you find us?
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If you choose to take classes with us which format would you prefer?
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Are there any children living in the household? *
How long have you had your dog? *
How did you acquire this dog? *
Please give a brief description of your reasons for seeking help with your dog? *
Dog's Name *
Dog's Sex *
Age or Birthday if known? *
Has the dog been spayed or neutered? *
Does the dog have any known health issues? *
Does your dog have any allergies? *
Dog's breed if known? *
If unknown please give size of dog
Where does the dog live? *
Does the dog run free in the neighborhood? *
Where does the dog sleep? *
Please describe the dog's personality? *
Has there been any significant changes in the dog's environment lately?
Check all that apply
How often is the dog fed? *
Is the dog left alone during the day? *
How long is the dog left alone in a day? *
Is the dog house trained? *
Is the dog crate trained? *
Has the dog had any formal training? *
What style of collar does the dog wear? *
For everyday wear and also training. Check all that apply
Behavior problems the dog has? *
Please check all that apply
Does the dog like other dogs? *
Does the dog like people? *
Is the dog frightened by any noises? *
What happens when you or somebody else tries to take food or toys from the dog? *
What cues does your dog know? *
Check all the apply
Rate the dog's energy level? *
Can the dog walk on a leash? *
Has the dog ever bitten anyone? *
Does the dog like to chase cats, squirrels, cars, etc? *
Any comments, questions or concerns?
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