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INTAKE QUESTIONNAIRE
Name
Email
Street Address
City
Province
Postal / Zip code
Phone Number
Dog's Name, Age, Breed, Colour
Names & Ages of Other Household Members
Availability
Day
Evening
Weekend
Select a date you wanted to start
Names, Species and Ages of Other Household Animals
What issues are you trying to resolve?
Where did you get your dog from?
What age were they when you got them?
What is your dog past training history? Please be specific with names of classes, trainers, and schools you have worked with.
What does you dog eat? (eg. kibble, raw, brand?)
Where does your dog sleep?
Does your dog have any medical conditions? (Either diagnosed or suspected including allergies, etc.)
Is your dog on any medications or supplements?
Does your dog have a bite history
Is your dog current on their vaccines?
*
Required
Yes
No
We do titre testing and limited vaccine protocols
What does your dogs day look like typically? (sleep, feed, exercise, play, etc.)
Does your dog attend daycare or go with a walker? If so what company?
What have you been doing to manage or work on the behaviour so far?
How would you describe your dog? Check all that apply.
*
Required
Generally Anxious
Anxious in Specific Context
Intense
Unable to Settle
Fearful
Loving
Lethargic
Grumpy
Unpredictable
Difficult to handle
Compulsive
Reactive
Aggressive
Predictible
Anything else you think we should know?
SUBMIT
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