Dog Training Services at 4333 W 10th Ave, Vancouver, BC.
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Name
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Email
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Pet Name
What Sex is your Dog?
Intact Female
Spayed Female
Intact Male
Neutered Male
Breed
Are there any accommodations we can make to best support you? (E.g: hearing challenges)
How much does your dog weigh?
How old was your dog when you first brought them home?
Has your dog been prescribed medication for behaviour?
Yes, my dog is currently on behaviour medications
Yes, my dog has previously been on behaviour medications
No, my dog has never been on behavioural medications
If you answered "yes" to the previous question, please describe your dog's past or current behaviour medication
Does your dog have any health concerns including chronic conditions, physical limitations, physical sensitivities or digestive sensitivities that we should be aware of?
Is your dog on any medication currently not related to behaviour? If so, please describe
Does your dog have any food allergies or dietary requirements?
Please check all applicable answers regarding your dog's relationship with food
My dog will eat any food, at any time
My dog sometimes turns their nose up at kibble or "boring" treats
My dog is generally excited to eat novel, "exciting" foods like cheese or meat
My dog eats food inside, but stops eating the same foods when outdoors.
My dog eats food reliably, except in the context of the problem behaviour
I free feed my dog (food is always left out)
My dog has regular, set mealtimes
My dog doesn't always finish their food
My dog is generally uninterested in food, including high value treats
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Please check all that apply to your dog
Fear (running away, trembling, cowering, freezing or hiding)
Reactivity (barking, lunging) towards people
Reactivity (barking, lunging) towards dogs
Aggression (growling, snapping, snarling, biting) towards people
Aggression (growling, snapping, snarling, biting) towards dogs
Aggression around food, sleeping spots, toys or chews
Barking
Separation Anxiety
Elimination indoors
Humping, Jumping Up, Nipping, Mouthing (Hyper-Arousal Behaviour)
Chronic Stress (pacing, whining, poor sleep, sudden startle, hyper-alert behaviour, fear)
Other
If you selected more than one behaviour above, please list which behaviours you feel are most important to address right now and those you feel are least important to address. The questions below will be in reference to your main behaviour concern.
If you answered "other", please describe the problem behaviour briefly (we will ask for specific examples in the next section)
What is the frequency of the most concerning behaviour?
Multiple times per day, every day
Once or twice per day
A few times per week
A few times per month
Infrequently
Infrequently, but only because I avoid the specific context in which the behaviour occurs
What general circumstances does your dog perform the main behaviour?
When did you first notice this issue? (age of dog)
When did this issue become a serious concern for you?
Has this problem changed in frequency since you first noticed it?
Less frequent
About the same
More frequent
I'm not sure
Has the problem changed in intensity since you first noticed it?
Less intense
About the same
More intense
I'm not sure
How predictable is the problem behaviour?
Extremely predictable. I always know it will happen, before it does.
Very predictable. It doesn't always happen, but if it does, I could see it coming.
Somewhat predictable. I can't always see it coming, but in hindsight, the behaviour fits within a larger pattern
Less predictable. I never see it coming, but the behaviour does fit within a pattern.
Unpredictable. I never see it coming, and the circumstances in which it happens seem unrelated.
I'm not sure.
Which of the following best describes your feelings about the problem behaviour?
I'm just curious, the problem isn't serious
The problem is annoying and I'd like to resolve it, but it isn't serious
The problem is very serious but if it can't be resolved, I'll still keep my dog
The problem is very serious and if it cannot be resolved, I will not be able to keep my dog
If you have a secondary behaviour concern, please list it here and let us know the general circumstances when your dog performs the secondary problem behaviour?
When did you first notice this second issue? (age of dog)
When did the second issue become a serious concern for you?
Has this second problem changed in frequency since you first noticed it?
Less frequent
About the same
More frequent
I'm not sure
Has the second problem changed in intensity since you first noticed it?
Less intense
About the same
More frequent
I'm not sure
What outcomes are you hoping to achieve from working with us?
Please Describe the most recent incident: -When did this occur? - Where did this occur? - What happened immediately before the incident? - What did your dog do during the incident? - What happened immediately after the incident?
Please Describe the Second most recent incident: -When did this occur? - Where did this occur? - What happened immediately before the incident? - What did your dog do during the incident? - What happened immediately after the incident?
Are there any other incidents you'd like to let us know about? If so, please describe them here.
If you have a secondary behaviour concern, please describe the most recent incident
What have you tried so far to resolve the problem behaviour? How effective has this been?
Is there anything else you'd like us to know before we set up our behaviour consult?
Please list everybody in your household, include the ages of any children and whether you have any other pets (include what type of pet).
Please describe any difficult relationships between your dog and other members of your household (including with other pets), if applicable
Please check all that are relevant
My house opens up onto a busy street, which can be difficult for my dog
My house has narrow/tight areas where my dog sometimes feels trapped
I don't trust my dog to free roam the house without supervision
My dog stays in a "puppy proof" area or crate when not actively supervised at home
My dog has full access to my home when I am away
My dog has access to a yard
My dog is overly interested in the window(s) or noises outside the home
I have some concerns about my dog and the neighbours
My dog frequently travels in the car without issue
I do not have regular access to a car
Have you moved since bringing your dog home? If yes, and the move was difficult for your dog to adjust to, please describe.
How do you exercise your dog? Check all that apply
Off leash dog parks
Off leash trail walks
Longline trail walks (15+ ft leash)
Neighbourhood leash walks
Fetch
Doggy Daycare (once per week or more)
Dog walker (once per week or more)
I cannot / do not let my dog off leash
Dog training / Dog sports
Other
How would you describe your dog's activity levels?
Low activity
Medium activity
High activity
Excessively high activity
Please check the most applicable
I have a weekly routine, which rarely changes. Life is very predictable for my dog.
I have a routine, but I often deviate from it. Life is largely predictable for my dog.
I have no set routine. Life is somewhat unpredictable for my dog.
Life is very unpredictable for my dog. E.g. we're on the road a lot, or my dog is shared between two homes
How would you rate your dog's sleep?
My dog sleeps overnight and naps frequently throughout the day (12+ hours of sleep per day)
My dog sleeps frequently but often startle awake, or wakes up frequently during the night
My dog is not getting enough sleep (less than 10 hours per day)
I'm not sure
What equipment do you typically use with your dog? Check all that apply
Regular Leash (6 ft - 12 ft)
Longline (15 ft + leash)
Flat (regular) collar
Martingale collar
Prong collar
Head halter
Front clip harness
Back clip harness
Choke chain
Slip leash
E-collar
Retractable / Flexi leash
Waist leash
Muzzle
How does your dog behave with unfamiliar visitors? Check any that apply
Generally friendly or excited, but will settle quickly
Excited, may jump up or mouth guests and struggles to settle
May urinate when new people arrive
Unfriendly, will struggle to settle with new people in the house and will NOT want to greet them
Hostile, will bark, lunge or aggress towards strangers in the home
What kind of training has your dog received in the past?
None
Trained at home / self taught
Started dog training classes but did not finish or practice
Graduated a puppy class
Graduated a basic obedience course
Graduated intermediate or advanced training classes
Private 1-on-1 lessons for behaviour modification
If applicable, how effective has private training for behaviour modification been in the past?
Which of the following techniques have you tried in the past?
I haven't tried anything
Food reinforcement
Clicker
Toys
Leash Corrections (flat or martingale collar)
E-collar Corrections
Leash Corrections (prong/pinch collar or choke chain)
Citronella collar
Bark collar
Spray bottle / can of coins or other "startle"/"Shhht" correction
Physical corrections (pinning, rolling, scruff shakes)
Check all cues your dog understands (at home under ideal circumstances)
Sit
Down
Stay
Recall
Loose Leash Walking
Drop
Leave It
Touch / Hand Target
Check if your dog knows any additional trick behaviours (e.g. spin, shake a paw, jump up)
Check if your dog knows any additional obedience behaviours (e.g. heelwork, stand for exam)
Your dog's training skills - check all that apply
My dog needs to see the food first, before they will do the behaviour
My dog follows cues under most circumstances
My dog won't follow cues in the context of the problem behaviour
My dog struggles if there are distractions nearby, or in new spaces
I need to use very high value food if there are distractions nearby
My dog follows cues if they know I have a ball or toy
Has your dog ever bitten a person or dog? (If your dog has never bitten a person or a dog, you may skip this section and submit your answers)
-- Select One --
Yes
No
How many separate times has your dog bitten a person?
How many separate times has your dog bitten a dog?
Please describe the severity of the bite towards humans (if multiple bites, choose the most severe)
Dog made contact but did not leave any marks or damage
Dog ripped clothing, but caused no injury
Puncture wound from a single bite (tooth broke the skin). Shallow wound not requiring medical attention
Multiple puncture wounds from two or more bites in a row. Shallow wounds, not requiring medical attention
Deep puncture wound from a single bite, required immediate medical attention
Multiple deep puncture wounds, required immediate medical attention
No puncture wounds, but bruising (from "muzzle punch" or dog biting and shaking)
Please describe the severity of the bite towards dogs (if multiple bites, choose the most severe)
Dog made contact but did not leave any marks or damage
Dog ripped out hair, but caused no injury
Puncture wound from a single bite (tooth broke the skin). Shallow wound not requiring medical attention
Multiple puncture wounds from two or more bites in a row. Shallow wounds, not requiring medical attention
Deep puncture wound from a single bite, required immediate medical attention
Multiple deep puncture wounds, required immediate medical attention
No puncture wounds, but bruising (from "muzzle punch" or dog biting and shaking)
My dog has killed another dog
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