Courteous Canine, Inc.

Name*

Email*

Address*

Phone*

What pronoun do you prefer?

She/Her/HersHe/Him/HisThey/Them/Theirs

How did you hear about us?*

Requested Dates for Board and Train:*

What are the top 3 goals you are looking to accomplish?*

Pet Name*

Breed*

Birthday*

Sex*

Spayed or Neutered *

YesNoUnknown

How long have you owned this dog? (rounded in years)*

Where did you get this dog? (Please list name of shelter, breeder, etc.)*

Has your dog been seen by a board certified Veterinary behaviorist or a vet for any behavior problems?*

YesNo

Is your dog or has your dog ever been aggressive towards people? *

YesNo

If yes, please describe:

Is your dog or has your dog ever been aggressive towards other dogs?*

YesNo

If yes, please describe:

Does your dog get along with cats?*

YesNo

Is your dog or has your dog ever been aggressive toward small animals (cats, chickens, etc.)? *

YesNo

If yes, please describe:

Is your dog reactive and/or fearful of other things (bikes, vacuum, etc.)? *

YesNo

If yes, please describe:

Is your dog reactive and/or fearful of any of the following (select all that apply):? *

List any equipment you use to walk your dog: *

Does your dog jump/climb fences?*

YesNo

If yes, what type/height:

Which most closely describes how your dog eats?*

Food is the best part of the day – barely stops to breathe Food is good – eats everything at a reasonable paceFood is so/so – may or may not finish a meal or needs "extras" to make it appetizingFree feed – food is out all the time

Does your dog bark a lot? *

YesNo

If so, list what he/she barks at (or situations in which they bark) and anything you've done to try to prevent it.

Does your dog chew or destroy any human items in the house or yard?*

YesNo

If so, please describe and also include anything you've done to try to prevent/correct it.

What treats does your dog like?*

Do they like to play with toys?*

YesNo

What kind of toys does your dog have/how many?*

What, if any, chewies do you offer them (rawhides, bones, etc.)?*

Is your dog house trained? *

YesNoPartly

Where does your dog stay while you are gone?*

Is your dog loud or destructive while you are gone?*

YesNo

If yes, please describe:

Where does your dog spend most of their time when you are home?*

Is your dog okay sleeping in a crate?*

YesNo

What cues does your dog know? Please check all that apply:*

By selecting the field below I agree to provide up to date shot records for my dog prior to my first appointment by emailing shot records to LoveDogs@CourteousCanine.com*

Board and Train Contact Us form

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