Connect with Canines

Name*

Email*

Address*

Phone*

Pet Name*

Breed*

Birthday*

Sex*

Where you did you get your dog?*

How old was your dog when you brought him into your home?*

Who is your dog's veterinarian?*

What is your veterinarian's phone number?*

Do I have permission to contact your veterinarian to discuss health and behavioral issues?*

Is your dog spayed or neutered?*

Please list all of your dog's current medical conditions (type N/A for none)*

Please list all of your dog's current medications (type N/A for none)

Please list all of your dog's allergies (type N/A for none)

Is your dog on monthly preventatives for flea, tick and heartworm prevention?*Flea onlyTick onlyHeartworm onlyFlea, Tick, Heartworm combo

Is your dog easily handled by vet staff?*

Please upload a copy of your dog's vaccination records.

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Please list all the people who live in the househould.

Please list the ages of all children in the household

Does anyone in the household dislike the dog?*

Are any members of the household frightened by the dog?*

Is the dog afraid of anyone in the household?*

Where is your dog kept when you are not at home?*

If your dog is kept confined during the day, on average, how long is he or she confined for?

What type of food do you feed your dog?*

How much food do you feed your dog in one setting?*

How often do you feed your dog?*

Does your dog get treats?*

How many days a week are you exercising your dog?*

How many times a day are you exercising your dog?*

How long are your dog's average exercise session?*

Who is normally responsible for exercising your dog?*

What type of collar or harness do you use to walk your dog?*Flat / Buckle collarMartingale (Greyhound collar)Choke chain (chain slip collar)Prong (pinch) or Starmark collarBody harness (back clip)No pull harness (front clip)Gentle Leader or Halti head collarE-Collar (shock collar)Other

Has your dog ever had to be muzzled*

If your dog had to be muzzled, what where the circumstances?

Does your dog like to play?*

Does your dog like to be pet?*

Does your dog like treats?*

What kind of treats does your dog like best?*

Does your dog try to chase things? *

How does your dog respond to sudden environmental changes in his environment? (People entering/leaving room, getting up from furniture, reaction to skateboards/bikes/golfcarts, reaction to things suddenly appearing in view)*No responseLooks at but ignoresLooks at and backs awayLooks at and barksLooks at and barks and lungesLooks at and tries to chase

Is your dog housetrained?*

Is your dog crate trained?*

What training methods were used previously?*Positive Reinforcement (treats, toys, praise)Punishment (Leash pops, physical/verbal corrections)Mixture of the two above styles

Did you complete the training program?*

What level of training did your dog last complete? *

If "aggressive" please describe (type N/A if not showing aggressive signs)

If your dog has become possessive was it towards another animal or a human or both?*

Has your dog ever nipped or bit anyone? *

Has your dog ever nipped or bit another dog?*

How many times has your dog nipped or bit another person?*

Did the dog know the person he or she nipped or bit?*

What was the scenario in which the nip or bite occurred?

How many times has your dog bit another dog?*

Did the bite require medical attention?*

What are your training goals?*

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