Obedience Intake Form

How long have you owned them?

Less than 1 year

More than 1 year

More than 2 years

Has your dog bitten another dog?

Yes

No

If yes, what is the worst result that has occurred?

snap

contact with zero damage

nip with bruising

punctures

gash or tear

fatality or mutilation

none of the above

Has your dog bitten a person?

Yes

No

If yes, what is the worst result that has occurred?

snap

contact with zero damage

nip with bruising

punctures

gash or tear

fatality or mutilation

none of the above

Is your dog reactive towards dogs?

Yes

No

Is your dog reactive towards kids?

Yes

No

Is your dog reactive towards adults?

Yes

No

Does their reactivity behavior usually occur in conjunction with;

being behind a fence

being on leash

being in the car

in home

none of the above

other

Number of dog friends?

many

1 or 2

none

Warms up to a new dog:

quickly

slowly

over many meetings

upon first meeting

never

Prefers? (Dogs)

Male

Female

Prefers? (Dogs)

Adult

Puppy

Prefers? (Dogs)

Small

Big

Prefers? (Humans)

Males

Females

Children

None of the above

Desired toy drive increase

Tug

Ball

Flirt pole

None of the above

How much training, if any, has your dog recieved?

Puppy socialization

basic obedience

reactivity training from another trainer

protection

None of the above

Other

How much exercise does your dog currently get a day?

No exercise

Very little exercise dure to lifestyle limitation

10 minutes

30 minutes

An hour or more

other

Training Intake Form

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