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Owner's Information
Name
*
First
Last
Email
Phone
*
Dog's General Information
What is your dog's name?
What breed is your dog?
How old is your dog?
How much does your dog weigh?
Is your dog intact, spayed, or neutered?
Intact
Spayed
Neutered
Dog's History
Did you rescue your dog or acquire it from a breeder?
I rescued my dog
I acquired from a breeder
Other
If other, please explain:
Does your dog have any allergies?
*
Yes
No
If so, please explain
Does your dog have any medical conditions?
*
Yes
No
If so, please explain
Is your dog current on all vaccinations?
*
Yes
No
Dog's Behavioral History
Does your dog have separation anxiety?
Yes
No
Is your dog crate trained?
Yes
No
Does your dog have any formal training?
Yes
No
Does your dog have a bite history?
Yes
No
Does your dog pull on the leash?
Yes
No
Does your dog bark at strangers?
Yes
No
Is your dog aggressive towards people, dogs, or other animals?
Yes
No
Do you walk your dog on a harness, gentle leader, flat collar and leash, slip lead or prong collar?
Harness
Gentle Leader
Flat Collar and Leash
Slip Lead
Prong Collar
Is your dog allowed on the furniture?
Yes
No
Where does your dog sleep at night?
Briefly describe any behavioral issues your dog is struggling with.
Name
This field is for validation purposes and should be left unchanged.
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