Please describe your dog's flea/tick control and prevention program: *
Does your dog have any allergies? *
Does your dog have any physical disabilities? * Yes No
Please explain disability & cause:
What restrictions need to be placed on their activities?
Does your dog have any medical conditions? * Yes Yes No
If yes, please explain. If medication is used, please provide name and dosage:
Tell us about the details of your dog's diet (food brand & type, primary protein source, and feeding schedule):
How does your dog react to having his/her nails clipped?
Does your dog have any sensitive areas on his/her body? * Yes Yes No
If yes, please elaborate:
Where are your dog's favorite petting spots?
How frequently is your dog walked outside? How long are your walks?
Breed
Age
Male or Female? Male Male Female
Breed
Age
Male or Female? Male Male Female
Breed
Age
Male or Female? Male Male Female
Do any visitors bring their dog(s) to your house? * Yes Yes No
If yes, how do they get along?
How does your dog react to a stranger coming into your home or yard?
Does your dog ever bark or growl at anyone passing outside your home or yard? Has your dog ever lunged, growled, snapped, nipped, bitten and not broken skin or bitten and broken skin? * Yes Yes No
Are there any types and/or breeds of dogs your dog seems to automatically fear or dislike? * Yes Yes No
If yes, please explain?
How does your dog react to puppies?
How does your dog react to another dog approaching him/her in a park, at the beach, or on a walk? Pull, lunge, growl, bark, nip, bite, play bow, lay down, wiggle?
Does your dog play with other dogs? * Yes No
Please describe size, breed, & temperament of the other dogs.
What kinds of games does your dog play with people?
Has your dog ever shared his/her food or toys with other animals? * Yes Yes No
If yes, how does your dog react to another dog approaching his/her food or toys?
Other tricks or commands:
If other, please explain:
Is it effective in keeping him/her under control? * Yes Yes No
Has your dog ever gotten away from someone when out for a walk? * Yes No
If Yes, please explain:
In which room in the house does your dog sleep?
Has your dog ever jumped up on someone? * Yes Yes No
If Yes, please explain:
What does your dog do to show he/she is happy?
What does your dog do to show he/she is upset?
Is this your first dog? * Yes No
Is your dog crate trained/can be alone? * Yes No
Has your dog shown signs of separation anxiety? * Yes No
Are there any particular types of people your dog seems to automatically fear or dislike?
Has your dog ever growled at someone? * Yes Yes No
If Yes, what were the circumstances and how did you respond?
Has your dog ever bitten a person? * Yes Yes No
If Yes, what were the circumstances, how did you respond, and what were the injuries (if any)?Paragraph Text
Has your dog ever bitten another animal? * Yes Yes No
If Yes, what were the circumstances, how did you respond, and what were the injuries (if any)?
To the best of your knowledge, what does your dog do when you're not at home?
Has your dog ever climbed/jumped a fence? * Yes Yes No
If Yes, what were the circumstances? How high was the fence?
Has your dog ever escaped from your house or yard? * Yes Yes No
If Yes, what were the circumstances?
How would you describe the energy level of your dog? *
Has your dog ever chased or tried to chase a small animal? * Yes Yes No
If Yes, what were the circumstances?
Has your dog ever chased someone (or wanted to) on a skateboard or bicycle? * Yes Yes No
If Yes, what were the circumstances?
Is your dog frightened by thunderstorms? * Yes Yes No
If Yes, describe the typical behavior & what specifically helps to relax your dog or calm his/her fear.
Is your dog frightened or nervous around anything else? * Yes Yes No
If Yes, please explain.
Does your dog play with any toys? * Yes Yes No
If Yes, what kinds of toys does your dog like?
Has your dog ever growled or snapped at a person who has taken food or toys away from him/her? * Yes No
If yes, what were the circumstances and how did you respond?
Has your dog ever growled or snapped at another dog who has taken food or toys away from him/her? * Yes No
If yes, what were the circumstances and how did you respond?
Have you ever noticed your dog stopping and staring at another animal? * Yes Yes No
If yes, what were the circumstances?
Other comments about your dog which you feel might be helpful.
How did you hear about us?
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