Questionnaire Behavior Consultation - Speak Fido Dog Training

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Behavior Consultation Questionnaire

*Completing this questionnaire is only for behavior modification consultations. If you are unsure if this is the right consultation for you, please call or email us first.*

Name(Required)

First Last

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

Your Dog

Dogs Name(Required)

Breed(Required)

Coat Colors(Required)

Age(Required)

Veterinarian(Required)

Spayed/Neutered(Required)

Yes

Date of last checkup(Required)

MM slash DD slash YYYY

Date of last rabies vaccine(Required)

MM slash DD slash YYYY

Medications, allergies or other medical information I should know about.

How many other dogs in your home?(Required)

How many people in your home?(Required)

Include ages of any children

Behavior History

Where did you get your dog?(Required)

How long have you had your dog?(Required)

What training experience does your dog have?(Required)

What training tools have you used with your dog?(Required)

E.g., chain collar, pinch collar, E-collar, invisible fence, harness, gentle leader, etc.

Is your dog potty trained?(Required)

Yes

If no, how many accidents does your dog have a day? Where do they happen?

Number of hours your dog is home alone a day:(Required)

When left home alone where is your dog kept?(Required)

Is your dog crate trained?(Required)

Average hours of exercise your dog gets a day?(Required)

Does your dog have any history of separation anxiety?(Required)

Yes

Unsure

Has your dog displayed any of these aggressive behaviors when resources like food or toys are taken away?(Required)

Freezing in place/over the item

Growling

Snarling

Snapping

Biting

Other

Has your dog displayed any of these aggressive behaviors when encountering people?(Required)

Barking

Growling

Snarling

Snapping

Biting

Other

Has your dog displayed any of these aggressive behaviors when encountering other dogs?(Required)

Barking

Growling

Snarling

Snapping

Biting

Other

In order of importance, list the behavior issues you would like to address.(Required)

e.g. potty training, leash walking, recall, stealing socks, etc.

When did you notice these behavior issues start?(Required)

Where did you hear about Speak Fido Dog Training?(Required)

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