Training Questionnaire

Email*

Name*

Address*

Street Address Address Line 2 City State ZIP Code

Phone

Please upload a picture of your dog

Max. file size: 2 MB.

How did you hear about us?

Dog's Name*

Male or Female*

Dog's Breed*

Dog's Date of Birth

Dog's weight (lbs)*

Is your dog spayed or neutered?*

Yes
No
Other

Spayed / Neutered Explanation

How long have you had your dog?*

What kind(s) of training have you tried?*

What behaviors do you want to work on? Check all that apply.*

Please explaing other behaviors to work on*

Any other behaviors you need to work on? Please describe here:

Has your dog ever bitten a person?*

Yes
No

If "yes" to above please describe.

Has your dog ever bitten another dog?

Yes
No

If "yes" to above please describe.

What do you do for exercise for your dog and for how long?*

Are you interested in a specific program with us that you saw on our website or heard about?

Do you do any enrichment activities? if yes please describe.*

When do you want to start?*

In a week or two
In 3-4 weeks

Do you want us to do most of the work for you?*

Yes
No
Other

Explanation - you want us to do most of the work

Are you interested in (check one) Please look at our programs on our website: lifeisdogpetcare.com*

Private training with you and your dog
Private training mostly done by us
Group Training
A combination of private and group training
Other

Other Training Interests - Explanation*

Does your dog have any food allergies or medical conditions?*

Is your dog on any medication?*

Is your dog crate trained quiet and relaxed in the crate with out barking or crying*

Yes
No

Does your dog play with other dogs?

Yes
No
Other

Dog Play - Explain Other

What is your general availability for the training sessions?*

Day (Monday-Sunday)	8am-12pm	12pm-4pm	4pm-7pm	Notes:

Click on the plus icon to add more options. Please note the more flexible and the more options will be easiest to schedule.

Does your availability for Training match your availability for a consultation?*

Yes
No

If No, fill in your availability for a consultation*

Day (Monday-Sunday)	8am-12pm	12pm-4pm	4pm-7pm	Notes:

When approached directly by an unfamiliar person while being walked on leash. 0=no signs of aggression 2=growling barking baring teeth 4 = Serious snaps/bites or attempts to*

0 (No visible signs of aggression)
1
2
3
4 (Serious aggression: snaps bites or attempts to)

When toys or objects are taken away by a household member. 0=no signs of aggression 2=growling barking baring teeth 4 = Serious snaps/bites or attempts to*

0 (No visible signs of aggression)
1
2
3
4 (Serious aggression: snaps/bites or attempts to)

When approached directly by a household member while the dog is eating. 0=no signs of aggression 2=growling barking baring teeth 4 = Serious snaps/bites or attempts to*

0 (No visible signs of aggression)
1
2
3
4 (Serious aggression: snaps/bites or attempts to)

When mailmen or delivery workers approach your home. 0=no signs of aggression 2=growling barking baring teeth 4 = Serious snaps/bites or attempts to*

0 (No visible signs of aggression)
1
2
3
4 (Serious aggression: snaps/bites or attempts to)

When food is taken away by a household member. 0=no signs of aggression 2=growling barking baring teeth 4 = Serious snaps/bites or attempts to*

0 (No visible signs of aggression)
1
2
3
4 (Serious aggression: snaps/bites or attempts to)

When approached directly by an unfamiliar dog while on leash. 0=no signs of aggression 2=growling barking baring teeth 4 = Serious snaps/bites or attempts to*

0 (No visible signs of aggression)
1
2
3
4 (Serious aggression: snaps/bites or attempts to)

When strangers walk past your home with your dog outside in the yard 0=no signs of aggression 2=growling barking baring teeth 4 = Serious snaps/bites or attempts to*

0 (No visible signs of aggression)
1
2
3
4 (Serious aggression: snaps/bites or attempts to)

When barked, growled, or lunged at by another unfamiliar dog. 0=no signs of aggression 2=growling barking baring teeth 4 = Serious snaps/bites or attempts to*

0 (No visible signs of aggression)
1
2
3
4 (Serious aggression: snaps/bites or attempts to)

When approached directly by an unfamiliar person while away from home. 0=no signs of fear 2=moderate fear 4 = extreme fear cowers, retreats or hides*

0 (No visible signs of fear)
1
2
3
4 (Extreme fear: cowers retreats or hides)

In response to sudden loud noises (e.g.thunder, car, vacuum, objects dropping). 0=no signs of fear 2=moderate fear 4 = extreme fear cowers, retreats or hides*

0 (No visible signs of fear)
1
2
3
4 (Extreme fear: cowers retreats or hides)

When an unfamiliar person tries to pet your dog. 0=no signs of fear 2=moderate fear 4 = extreme fear cowers, retreats or hides*

0 (No visible signs of fear)
1
2
3
4 (Extreme fear: cowers retreats or hides)

When an unfamiliar dog approaches. 0=no signs of fear 2=moderate fear 4 = extreme fear cowers, retreats or hides*

0 (No visible signs of fear)
1
2
3
4 (Extreme fear: cowers retreats or hides)

When exposed to new or unfamiliar situations (first car trip, first vet visit) 0=no signs of fear 2=moderate fear 4 = extreme fear cowers, retreats or hides*

0 (No visible signs of fear)
1
2
3
4 (Extreme fear: cowers retreats or hides)

When barked, growled at or lunged at by an unfamiliar dog. 0=no signs of fear 2=moderate fear 4 = extreme fear cowers, retreats or hides*

0 (No visible signs of fear)
1
2
3
4 (Extreme fear: cowers retreats or hides)

When seeing an unfamiliar object on the sidewalk (plastic trash bag, litter, flag moving) 0=no signs of fear 2=moderate fear 4 = extreme fear cowers, retreats or hides*

0 (No visible signs of fear)
1
2
3
4 (Extreme fear: cowers retreats or hides)

When having nails trimmed by a household member. 0=no signs of fear 2=moderate fear 4 = extreme fear cowers, retreats or hides*

0 (No visible signs of fear)
1
2
3
4 (Extreme fear: cowers retreats or hides)

Separation related behaviors: some dogs show signs of anxiety when left alone, over the last 6 months.

Restlessness/agitation/pacing*

Barking and whining*

Chewing scratching at the doors, floor, windows, curtains etc.*

Attachment and attention seeking: over the last 6 months how often has your dog shown each of the following.

Tends to follow you or other household members room to room*

Tends to sit close to, or in contact with, you or others when you are sitting*

Miscellaneous problems

Chases or would chase birds given the chance*

Chases small critters given the chance*

Escapes or would escape the home or yard given the chance*

Chews innapropriate objects*

Pulls excessively on leash*

Hyperactive, restless, difficulty settling down*

Playful, puppyish, boisterous*

Active, energetic, always on the go*

Chases own tail, or hind end*

Barks persistently when alarmed or excited*

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Phone

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+508-319-9077

Training Questionnaire

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