Basic Info & Behavior HistoryBasic Info & Behavior HistoryBasic Info & Behavior HistoryClient's Name(Required) First Last Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Email(Required) Basic InformationDog's name(Required)Dog's ageBreed/MixIs your dog spayed or neutered? Spayed Neutered NoHow old was your dog when you acquired them?Has the dog had previous owners? Yes NoWhere did you get your dog?Have you owned other dogs in the past?Diet & Daily CareWhat do you feed your dog?How often?How do you feed them?Describe your dog's feeding habits. Finicky, good or voracious?How often does your dog exercise?Briefly describe your dog's daily routineWhat kind of equipment do you use to walk your dog?What sort of play does your dog enjoy most?Do you use a crate? If yes, when did you begin to crate your dog?How many hours a day is your dog kept in the crate?Where does your dog sleep?Household & SocialPlease describe the general social layout of the family (children, other adults and animals) and the dog's place in itHas your household changed since acquiring your dog? If yes, please describeDoes your dog enjoy children? If no, please describe your dog's reaction to the sight of children.Describe how your dog reacts to guests and strangersTraining HistoryHas your dog ever received formal training? If so, when and where?What training methods or philosophy did the trainer emphasize?Please briefly describe the benefits and impressions from trainingBehavior ConcernsWhat is/are the reason(s) for your inquiry?How often does the problem occur? Rarely Occasionally FrequentlyHas there been a recent change in frequency or severity?What have you done so far to correct your dog's behavior problem?Has your dog been socialized with unfamiliar dogs outside of your home? If yes, when and where?Has your dog been exposed to a group of dogs, such as at a dog park or doggie daycare? If so, how often?Has your dog ever bit anyone or anything? Yes NoIf yes, please describe the incident including the severity of bite (was there puncture, blood) and circumstances in as much detail as possibleAnything else that you think I should be aware of?Δ
