Street Address Line 2
Children in the house under age 18?
If yes, names and ages of all children
Information about your dog
Age / Date of Birth
Spayed / Neutered
Breed (or cross-breeds if known)
Where does the dog eat?
Brand dog food
Dog's main food source (tick all that apply)
Dry Food / Kibble / Nuts
Wet / tinned food
Home cooked dog meals
Raw dog food diet
Scraps / table scrapings / leftovers
What times does s/he eat?
Does your dog have any food allergies
Please list any known allergies
Does the dog finish the meal straight away?
Is anyone (or other pets) nearby when the dog eats? Who?
How many walks per day/week
How long is each walk?
Play during the day
How long does the dog get played with every day?
What would you like your dog to learn to do
Housetraining/ appropriate toilet behaviour
Eye contact / name recognition
Accept handling and grooming
Walk on loose lead
Go to bed / crate training
Come Here / Recall
Anything you would like the dog to learn not listed above
What would you like your dog to stop doing
Jumping on visitors / people
Puppy or play nipping
Bolting out the door
Biting (aggressive / defensive - not in play)
Lunging at people/dogs/cars on walks
If you selected Biting, barking, lunging or growling, please describe in detail when these are happening
You may be asked to fill in a behavioural questionnaire based on your answer
Anything you would like your dog to stop not listed above
What equipment are you currently using
Bed on floor
Slip lead / choke chain
Fixed length lead
Long-line or tracking line (5 meters or more)
Electric / stim / vibration collar (or invisible fencing)
Adaptil plug in
What are your dog's 3 favourite snacks/treats
What are your dog's 3 favourite toys/game
What enrichment toys/food puzzles do you have (eg., Kong)
What tricks/cues/commands does your dog already know
Go to bed / go to place
How were these taught (select all that apply)
Don't know / unknown
Luring (showing the dog food to get into position, then feeding)
Moulding (placing hands on dog to guide into position)
Reinforcement (saying cue/command then rewarding with food or play after achieved)
Rattle can / startle device
Tipping on nose
Slapping / hitting or other physical punishment
For unwanted behaviours, what happens right before the dog does it?
eg., someone walks past window, dog barks, visitor arrives at door, dog jumps
Please describe your dog's day in detail from waking in the morning to going to sleep at night. Include toilet breaks, play, walk, naps, time left alone, etc.
Where did you hear of us
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