Your Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Dog's Name

First Name

Last Name

Breed (or best guess)

Dog's age when acquired and dog's current age

Dog's Weight

Dog's Gender

License/Microchip #

Spayed/Neutered?

Where did you obtain your dog?

How long have you owned your dog?

Preferred Method of Contact

Check all that apply

Phone

Text

Please list the members (2 and 4 legged) of your household

Include name, age, gender and hours away from the home for each person or pet

Additional Family Members

Describe your dog's daily routine

What type of exercise does your dog get on a daily basis?

Leashed walks? Off-leash walks or hikes? Dog park? Fetch? Etc.

Is your dog up-to-date on vaccinations (DHPP, Rabies?)

What is your dog like with strangers/visitors to the home?

What is your dog like with other dogs?

What training has your dog received?

What training methods have you used with your dog?

Has your dog ever snapped at or bitten a person?

Please describe the severity of the bite? Did it break skin?

How does your dog feel about sharing things/people/places with other dogs?

How does your dog feel about having people take his things (food, toys, chews) away?

What is your dog most motivated by? Treats? Toys? Attention? Access to sniffs?

Describe any arguments your dog has been in with other dogs

Is your dog on any medications? If yes please list:

What behavior issue(s) or complaint(s) are you currently experiencing? Please explain problem behaviors and goals:

Please describe the particular issue(s) in greater detail

When did you first notice the issue(s) and how and when do they occur?

What have you done so far to address these issues?

What do you hope to gain from the consult?

Pawsitopia Training Client Questionnaire

Dog Training ● Dog Walks ● Drop-in Visits
samantha@pawsitopia.com ● Truckee, CA