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?
Clear selection
If you choose to take classes with us which format would you prefer?
Clear selection
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? *
Hours
Hours
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
Required
Behavior problems the dog has? *
Please check all that apply
Required
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
Required
Rate the dog's energy level? *
Calm
Energetic
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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