Reactive Rover Questionnaire
Thank you for taking a few minutes to fill out this questionnaire so that we can make sure that Reactive Rover is the right class for you and your dog!
Owner Information
Owner's Name: *
Your answer
Email Address: *
Your answer
Phone Number: *
Your answer
Dog Information
Dog's Name: *
Your answer
Breed: *
Your answer
Sex:
Your answer
Age: *
Your answer
Dog's approximate weight: *
Your answer
Is your dog spayed or neutered? *
WHERE did you adopt or purchase your dog? *
Your answer
How long have you had your dog? *
Your answer
Are there other dogs in the household? *
If Yes, please list their breed, age, sex, and spay/neuter status below:
Your answer
Reactivity
When ON LEASH, what does your dog do when he/she sees another dog? *
Required
Of the above behaviors that you checked, at what distance from the other dog does the behavior occur? *
(ie "barks - 20 feet, snaps - 5 feet")
Your answer
When OFF LEASH, what does your dog do when he/she sees another dog? *
Required
Of the above behaviors that you checked, at what distance from the other dog does the behavior occur? *
(ie "barks - 20 feet, snaps - 5 feet")
Your answer
How many times per week does your dog play with other dogs? *
Your answer
Where?
Your answer
On or off-leash?
Additional comments:
Your answer
How many times per week do you and your dog play together in the presence of other dogs without focusing on them or interacting with them? *
Your answer
Has your dog ever been in a dog fight? *
How many times?
Your answer
Please describe the fight below:
Your answer
Was either dog hurt?
If yes, please describe the injuries:
Your answer
Did either dog go to the vet?
What does your dog do when he/she meets or sees a human stranger? *
Required
How many times has your dog bitten a person? *
Your answer
Did the bite break skin?
Did the person see a doctor as a result of the bite?
Please describe the incident:
Your answer
Training
Have you taken classes with your dog before, or has your dog worked with a private trainer? *
If so, please list the classes taken/training done, where, and when:
Your answer
What are the behavior and training goals you would like to achieve by attending Reactive Rover? *
Your answer
How did you hear about this class? *
Your answer
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