Owner's Name
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First Name
Last Name
Phone Number
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Email
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What type of home do you live in with your dog?
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House
Townhome
Condo
Apartment
Other
Do you have a yard or a patio?
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How did you hear about Believe in DOG Training?
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Have you read the "Must Read" and "Training Philosophy"Behavior Blueprints on our website?
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Dog's Name
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Breed or Breed Mix
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Gender:
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Female, spayed
Female, intact
Male, neutered
Male, intact
Dog's Current Age
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Dog's Age When You Got Him or Her?
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Where did you get your dog?
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Dog's Weight
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Which veterinary clinic do you use?
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When was your dog's last checkup?
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Other than heartworm and flea protection, does your dog take any medication regularly?
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Is your dog currently being treated for a medical condition of any kind?
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Does your dog have any condition that may cause frequent or chronic pain?
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Does your dog have any dietary restrictions?
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What are three things you love about your dog?
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How many people live with your dog?
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Do children under 16 ever visit your home?
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Ages of children who live with your dog?
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Please list all other pets that live in your home. Include their name, species, breed, gender, spay/neuter status, and age:
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Does your dog get along with other pets in the home?
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How would you describe your dog's personality or temperament?
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Select all that apply.
Does your dog regularly and successfully play with other dogs?
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How does your dog get along with human family members?
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How does your dog respond to strangers or visitors in your home?
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How does your dog respond to strangers or visitors outside of your home?
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Does your dog generally meet people on-leash or off-leash?
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Has your dog ever bitten a person? (other than normal puppy nipping)
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No
Yes
Do you know or suspect that your dog has been abused or neglected?
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When on-leash, how does your dog act when they see an unfamiliar dog on a leash?
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How close are you getting to other dogs on your walks?
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Are you greeting other dogs while your dog is on leash?
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When off-leash, how does your dog act when they meet or see an unfamiliar dog off of the leash?
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Has your dog ever bitten another dog?
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No
Yes
How do you feed your dog?
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Select all that apply.
What brand or type of food is your dog eating and how much do they eat per day?
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What kind of activities does your dog enjoy?
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How much physical exercise does your dog get per day? In what form?
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How often do you walk your dog?
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Do you enjoy walking your dog?
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What tools do you use to walk your dog?
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Select all that apply.
Are you taking treats with you on your walk?
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Yes
No
Sometimes
How much mental exercise does your dog get per day? in what form?
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Describe a typical day for you and your dog.
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How much time does your dog spend alone (without humans) per day?
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Where does your dog spend time when left alone?
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Have you done any previous training with your dog?
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No
Yes
Have you had prior behavior counseling for this dog?
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No
Yes
How do you respond when you dog does something right?
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How do you respond when you dog does something wrong?
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Describe any behavior you'd like to help your dog change:
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Can you recall any life change or event that coincided with the behavior issue starting?
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Have you sent us a video of the behavior? Use the form below to send us any videos you are able to capture of the unwanted behavior.
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