Pets4Life Dog Training Client Profile Help us get a better understanding of you and your dog! Step 1 of 5 20% YOUR DOG AND YOUR FAMILYTell us about yourself and your current living situation.Name(Required) First Last Phone(Required)Please provide your phone or mobile number in international format: (+61- ---- ----)Email(Required) Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Have you attended formal dog training with any dog before?(Required) Yes No Within Last 12 months Last 5 years Over 5 years ago Which dog? This dog Another dog What type? Positive Correction (choker chain) Combination Briefly describe any medical conditions you have that may impact on training (e.g. mobility, sight or hearing conditions):How many children live at your home?(Required)Please enter a number greater than or equal to 0.How many teenagers live at your home?(Required)Please enter a number greater than or equal to 0.How many adults live at your home (including yourself)?(Required)Please enter a number greater than or equal to 1.What age children do you have at home?(Required) 0–5 6–10 11–14 15–18 Select all that apply.Which of the following best describes the property you and your dog live on?(Required) Flat/Unit House with small yard House with medium yard House with large yard Hobby Property (up to 5 acres) YOUR DOGTell us about your dog.Name(Required) Please provide your dog's nameAge(Required) 0-6 months 6-12 months 1-2 years 2-6 years 7-9 years 9-11 years Older Breed(Required) Please provide the breed of your dog.Is your dog:(Required) Male Female Is your dog desexed?(Required) Yes No Do you intend to desex your dog?(Required) Yes No Colour(s)/identifying marks(Required) Describe briefly your dog's appearance.Approximate height (cm)(Required)Approximate weight (kg)(Required)Date of last vaccination(Required)Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Age of dog when obtained(Required) 0-6 months 6-12 months 1-2 years 2-6 years 7-9 years 9-11 years Older Obtained from where(Required) Pet shop Animal shelter Registered breeder Unregistered breeder Other Does your dog have any medical conditions?(Required) Yes No Describe the condition(s)(Required)Is this your first dog?(Required) Yes No Is this your only dog?(Required) Yes No What breed, age, and sex are your other dogs(Required) Add RemoveProvide information for one dog per row.Which of the following equipment have you used with this dog?(Required) Standard collar and lead Check/choker/slip collar Head halter Back attach harness Front attach harness Martingale/limited slip collar Citronella collar Electronic or ‘remote’ collar Invisible fence Prong collar Select all that apply. Dog InteractionPlease select the frequency that you use each method.Treats (e.g. dried liver, chicken strips, Schmackos or similar)(Required) Often Sometimes Rarely Never Toys (e.g. stuffed toys, tug ropes, balls)(Required) Often Sometimes Rarely Never Praise (e.g. "good dog/boy/girl")(Required) Often Sometimes Rarely Never Patting (e.g. stroking dog, patting its head)(Required) Often Sometimes Rarely Never Verbal punishment (e.g. "ah-ah", "no", "stop it")(Required) Often Sometimes Rarely Never Physical punishment (e.g. smack with hand/paper)(Required) Often Sometimes Rarely Never Hand gestures to ask for behaviours (e.g. point to floor for lie down)(Required) Often Sometimes Rarely Never Luring with food to teach behaviours (e.g. use a treat to lure dog to lie down)(Required) Often Sometimes Rarely Never Pushing the dog into position (e.g. push dog into a sit, or push to lie down)(Required) Often Sometimes Rarely Never Talk to your dog a lot (e.g. "good morning", "how are you?" "happy to see me?")(Required) Often Sometimes Rarely Never Play roughly with your dog (e.g. roughing-up dog’s head, wrestling)(Required) Often Sometimes Rarely Never Reassure your dog when it is nervous (e.g. "it’s okay", "don’t worry", "I’m here")(Required) Often Sometimes Rarely Never Dog BehaviourSelect how often your dog performs the following behaviours at home and away from home.AT HOME: Accepts friendly strangers approaching(Required) Usually Sometimes Rarely Never AWAY FROM HOME: Accepts friendly strangers approaching(Required) Usually Sometimes Rarely Never AT HOME: Sits politely to greet friendly strangers(Required) Usually Sometimes Rarely Never AWAY FROM HOME: Sits politely to greet friendly strangers(Required) Usually Sometimes Rarely Never AT HOME: Settles quickly when asked(Required) Usually Sometimes Rarely Never AWAY FROM HOME: Settles quickly when asked(Required) Usually Sometimes Rarely Never AT HOME: Responds to name/looks at you when asked(Required) Usually Sometimes Rarely Never AWAY FROM HOME: Responds to name/looks at you when asked(Required) Usually Sometimes Rarely Never AT HOME: Sits when asked(Required) Usually Sometimes Rarely Never AWAY FROM HOME: Sits when asked(Required) Usually Sometimes Rarely Never AT HOME: Lies down when asked(Required) Usually Sometimes Rarely Never AWAY FROM HOME: Lies down when asked(Required) Usually Sometimes Rarely Never AT HOME: Stands when asked(Required) Usually Sometimes Rarely Never AWAY FROM HOME: Stands when asked(Required) Usually Sometimes Rarely Never AT HOME: Goes to bed when asked(Required) Usually Sometimes Rarely Never AWAY FROM HOME: Goes to bed when asked(Required) Usually Sometimes Rarely Never AT HOME: Comes when called(Required) Usually Sometimes Rarely Never AWAY FROM HOME: Comes when called(Required) Usually Sometimes Rarely Never AT HOME: Stays in position for about 10 seconds(Required) Usually Sometimes Rarely Never AWAY FROM HOME: Stays in position for about 10 seconds(Required) Usually Sometimes Rarely Never AT HOME: Comes away from distractions when asked(Required) Usually Sometimes Rarely Never AWAY FROM HOME: Comes away from distractions when asked(Required) Usually Sometimes Rarely Never AT HOME: Walks on a loose lead most of the time(Required) Usually Sometimes Rarely Never AWAY FROM HOME: Walks on a loose lead most of the time(Required) Usually Sometimes Rarely Never AT HOME: Heels/walks close for about 5 steps(Required) Usually Sometimes Rarely Never AWAY FROM HOME: Heels/walks close for about 5 steps(Required) Usually Sometimes Rarely Never Who is your usual veterinarian and clinic(Required) When you are home, is your dog usually(Required) Outside Inside Some of both When your dog is left alone, are they(Required) Outside Inside Some of both How often is your dog exercised and how frequently does this occur (e.g. walked for 20 minutes twice per day)?(Required)Has your dog ever growled at, lunged at, or bitten a person, other than normal puppy mouthing?(Required) Yes No Describe the incident(s)(Required)Please tick any of the following that describe your dog(Required) Won’t let you take items from him/her * Not toilet trained * Over-excited when inside * Barks excessively * Digs excessively * Chases things * Chews/destroys things * Won’t settle in car * Pulls on lead Ignores requests Sits in front seat of car Enjoys walks Enjoys games Won’t walk on lead If you selected anything marked with an asterisk (*) please describe your dog’s behaviour(Required)How does your dog interact with people?(Required) Worried when people are absent * Suspicious/shy with strangers * Barks at some people * Growls at some people * Snaps at some people * Dislikes being handled * Dislikes children * Backs away from people * Moves toward people * Ignores new people * Bites at hands, feet, or clothes * Becomes overexcited * Plays too roughly * Jumps on people * Dislikes people in hats * Dislikes people in sunglasses * Dislikes people in coats/strange clothing * Likes to be with you Likes new people Likes children Likes being handled If you selected anything marked with an asterisk (*) please describe your dog’s behaviour(Required)How does your dog interact with other dogs?(Required) Likes other dogs Plays nicely with other dogs off-lead Don't know Barks at other dogs when on-lead * Barks at other dog when off-lead * Growls at other dogs when on-lead * Growls at other dogs when off-lead * Worried about other dogs * Plays too roughly * Lunges at other dogs when on-lead * Stares at other dogs when on-lead * If you selected anything marked with an asterisk (*) please describe your dog’s behaviour(Required)How does your dog interact with the environment? Doesn’t like water Worried about sudden noises Chases shadows Worried about storms Worried about wind Chases reflections Worried about traffic Worried about bikes/skateboards Chases pretend flies Describe your dog’s behaviour(Required)How do you feel when you take your dog out for a walk?Which of the following best describes how you see your dog?(Required) Pushy Independent Stubborn Excess energy Destructive Timid/shy Anxious Confident Likeable Which of the following describes how you feel about your dog at present?(Required) Frustrated Annoyed Confused Resentful Nervous Proud I love my dog I like my dog I tolerate my dog Which of your dog's behaviours would you most like to see improvement in (e.g. not pulling on lead, not jumping on people, etc.)?(Required)Any other comments you think will help with training or that you feel I should know about?How did you find out about my training services?(Required) Vet Clinic RSPCA/shelter Advertisement (e.g. newspaper, radio, magazine, etc.) Internet site Pet Shop Other trainer Breeder Friend Please specify(Required) Product Name(Required)Thinking of getting a puppy or adopting a dogJust before you bring home your new puppy or rescue dog (in person)Just before you bring home your new puppy or rescue dog (via Zoom)New baby puppy, prior to starting puppy pre-school (in person)New baby puppy, prior to starting puppy pre-school (via Zoom)Older puppy, young adolescent dogs, Adult dog (behavioural issues/manners/relationship building) (90 minutes in person)Older puppy, young adolescent dogs, Adult dog (behavioural issues/manners/relationship building) (follow up in person)Older puppy, young adolescent dogs, Adult dog (behavioural issues/manners/relationship building) (90 minute Zoom)Older puppy, young adolescent dogs, Adult dog (behavioural issues/manners/relationship building) (60 minute Zoom)Older puppy, young adolescent dogs, Adult dog (behavioural issues/manners/relationship building) (pack of 3)Total Credit CardPlease check your Stripe API Settings. 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