- Pets4Life Dog Training -
https://pets4life.com.au
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Pets4Life Dog Training Client Profile
Posted By
refuelcreative
On
July 19, 2023 @ 3:13 pm
In |
Comments Disabled
Help us get a better understanding of you and your dog!
Step
1
of
5
20%
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
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland 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 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
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)
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Month
1
2
3
4
5
6
7
8
9
10
11
12
Year
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
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
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
Remove
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
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 dog
Just 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 Card
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