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Training Intake Form
How long have you owned them?
Less than 1 year
More than 1 year
More than 2 years
Has your dog bitten another dog?
Yes
No
If yes, what is the worst result that has occurred?
snap
contact with zero damage
nip with bruising
punctures
gash or tear
fatality or mutilation
none of the above
Has your dog bitten a person?
Yes
No
If yes, what is the worst result that has occurred?
snap
contact with zero damage
nip with bruising
punctures
gash or tear
fatality or mutilation
none of the above
Is your dog reactive towards dogs?
Yes
No
Is your dog reactive towards kids?
Yes
No
Is your dog reactive towards adults?
Yes
No
Does their reactivity behavior usually occur in conjunction with;
being behind a fence
being on leash
being in the car
in home
none of the above
other
Number of dog friends?
many
1 or 2
none
Warms up to a new dog:
quickly
slowly
over many meetings
upon first meeting
never
Prefers? (Dogs)
Male
Female
Prefers? (Dogs)
Adult
Puppy
Prefers? (Dogs)
Small
Big
Prefers? (Humans)
Males
Females
Children
None of the above
Desired toy drive increase
Tug
Ball
Flirt pole
None of the above
How much training, if any, has your dog recieved?
Puppy socialization
basic obedience
reactivity training from another trainer
protection
None of the above
Other
How much exercise does your dog currently get a day?
No exercise
Very little exercise dure to lifestyle limitation
10 minutes
30 minutes
An hour or more
other
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