Behavior Questionaire

The information submitted is strictly confidental and is only used by Trainer Dale McCluskey to assist in the training process.

Your Name your first and last name

Address City and street address

Phone number

your email address

How many people in your home environment interact with your dog ? List how many people have direct interaction with your dog

Name of your dog

Breed of your dog any info on breed

male or female MaleFemale

Age of dog

Approx weight of dog

Describe your dog's personality In your own words

Describe your dog's daily routine

List the behaviors you want to change & goals Provide details

Has your dog been fixed YesNo yes or no

Where did you get your dog Store, humane society, breeder etc

Medical issues past or present

Where does your dog sleep on bed - on floor bedroom etc

How much activity and exercise does your dog get each day

How does your dog behave on the leash during a walk resists / walks out in front etc

If you have had prior obedience training explain outcome

Do you currently use or previously used devices and explain how your dog responds (ie choke chains, remote collars, clickers, treats etc)

How do you respond to behaviour you don't like punish after, ignore, correct at the time

Has your dog bitten anyone or shown teeth ? YesNo

If yes please provide complete details Details including where incident occurred, family member or stranger, on leash or off etc

How does your dog respond to strangers Approaching while walking on leash / coming to the door etc

How does your dog respond to other dogs Aggressive / mounts etc

If you have other pets how does your dog interact with them harasses them, calm, gets along etc

Does your dog follow one person around more than others ? Explain. If so have do you perceive this ? Love, not trusting others etc

Do you currently avoid situations with your dog If yes provide details

How frustrated do you currently feel about your dog's behaviour Very frustrated, somewhat, considering giving dog away etc

Additional information you would like me to know

If you are wanting to book a session please list a date and time you would like to schedule your first session.