Client Intake Questionnaire

Please fill out this Client Intake Questionnaire so I can come prepared for our first session. All these questions help me understand you and your dog better, so please be as detailed as possible. Thank you!

Name*

Email*

Address*

Phone*

Referred By:

Pet Name*

Breed*

Birthday (or best guess)?*

Sex*

Spayed/Neutered?*

No/yes

Dog's Vet + last vet visit/medical problems/meds/allergies? (Please list your vet's practice name, address, and phone number in case of emergency)*

How long have you had your dog? Where did you get him/her? *

Has your dog ever bitten/nipped or injured a person or animal? *

No/yes

If yes, please describe in as much detail as you can. If no, put N/A.

Other pets in the household? (If yes, please describe)*

Other people in household? (If yes, please describe)*

Occupation/Time spent outside of the home?*

Fed how many times per day? What times?*

Eats right away/finishes meals?*

Other treats/snacks? How often?*

Potty trained? (i.e. no accidents where you do not want your dog pottying)*

Crate trained? (does your dog go willingly and stay happily in the crate?)*

Is your dog comfortable being left alone?*

Where does your dog sleep?*

% of time spent indoors/ outdoors?*

Exercise type/frequency*

Equipment used on walks?*

Have you done any training with your dog, or had he/she done any before you adopted him/her? *

Can you describe the basic approach you learned to train your dog? *

Did you feel you got the results you were looking for? *

What are your dog's favorite foods/treats? *

What are your dog's favorite toys? *

What are your dog's favorite activities? *

Reason for consultation/ training goals (Please be detailed and list them in order of importance) *

What were your favorite moments this week with your dog? *

What were the worst moments this week with your dog? *

How much time are you willing commit to training your dog? *

Anything else I should know? *

List out your typical availability for sessions (both for day training sessions and transfer/follow-up sessions).*

Client Intake Questionnaire

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