Name
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First Name
Last Name
Your age
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Spouse/partner
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First Name
Last Name
Names and ages of all children who live with your dog.
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Cell phone number
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(###)
###
####
Email addresses
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Include all email addresses of those who would like to be included in the correspondence between us.
Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
How did you hear about Shake On It Pet Training?
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Dogs name
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Breed or breed mix
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Dog's age
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Dog's weight
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Gender
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Spayed/Neutered?
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Describe in detail the behavioral issues you are seeking help for.
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What have you done to try and solve the issues yourself?
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How long has your dog had these behavioral issues?
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What are your goals or aspirations for your dog?
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What days of the week would you prefer to schedule your lessons?
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What time of day would you prefer to schedule your lessons?
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How will your dog receive me as a guest in your home?
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How long have you had this dog?
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Where did you get your dog? If you acquired your dog through a shelter or other circumstance please provide any history or information you received about your dog.
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If you got your dog from a breeder please provide their contact info/website if available.
What other pets are living in your home?
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If there are conflicts between your dogs you must fill out a form for each dog.
Please check what type of home you live in.
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What do you feed your dog?
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Dry kibble, wet food, home cooked, raw...
How many days of the week does your dog receive 30 or more minutes of moderate to strenuous physical exercise?
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What kind of exercise, where, how long...
Where do you walk your dog? Check all that apply.
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Please list what kind of mental stimulation you provide for your dog.
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Please include how often you provide mental stimulation for your dog.
What veterinarian do you use?
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Underlying health issues are often the cause of many behavioral issues, have you discussed your dog's behavior with your vet?
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List all medications and supplements your dog is taking.
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List all allergies your dog has.
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Please check any of the following that has been or is currently being used on your dog.
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I do not use, or advocate the use of aversive training methods inc. pinch, prong, or shock (e-collars), or erroneous dominance/pack approaches. Are you open to exploring better ways to solve your dog's behavioral issues without those concepts and equipment?
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Describe your dog's past experiences with other dogs that they do not live with.
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Do you take your dog to dog parks?
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Describe exactly what your dog does when he/she sees another dog while on-leash.
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Barks, pulls on leash, lunges, growls, air snaps, bites, hackles up, tries to hide, sniffs quietly, etc.
Describe exactly what your dog does when he/she interacts with dogs off-leash.
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Barks, charges, lunges, growls, air snaps, bites, hackles up, runs away, hides, sniffs quietly, etc.
How many fights has your dog had with the other dogs in your home?
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How many fights has your dog been in with dogs that do not live in you home?
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Describe ALL the bites your dog has inflicted on the dogs that live in your home.
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Please be specific and detailed.
Describe ALL the bites your dog has inflicted on other dogs that do not live with you.
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Please be specific and detailed
Please check all the equipment you use with your dog while on walks
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Describe exactly what your dog does when he/she encounters strangers.
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Barks, charges, lunges, growls, air snaps, bites, hackles up, runs away, hides, sniffs quietly, etc.
Descrbe exactly what your dog does when a stranger tries to pet him/her.
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Barks, charges, lunges, growls, air snaps, bites, hackles up, runs away, hides, sniffs quietly, etc.
Describe all the bites your dog has inflicted on a human.
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Include severity, who it was, and approximate dates.
Is there anything else you would like to add?
