Pets4Life Dog Training Client Profile

Help us get a better understanding of you and your dog!

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YOUR DOG AND YOUR FAMILY

Tell 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 Country

Have you attended formal dog training with any dog before?(Required)

Yes

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 DOG

Tell us about your dog.

Name(Required)

Please provide your dog's name

Age(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

Do you intend to desex your dog?(Required)

Yes

Colour(s)/identifying marks(Required)

Describe briefly your dog's appearance.

Approximate height (cm)(Required)

Approximate weight (kg)(Required)

Date of last vaccination(Required)

Age 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

Describe the condition(s)(Required)

Is this your first dog?(Required)

Yes

Is this your only dog?(Required)

Yes

What breed, age, and sex are your other dogs(Required)

Provide 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 Interaction

Please 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 Behaviour

Select 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

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)

Total

Credit Card

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YOUR DOG AND YOUR FAMILY

YOUR DOG

Dog Interaction

Dog Behaviour

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