Consultation Form Please complete this form prior to your first training meeting. Thank you. *Required Your Name Your Email Your Dog's Name Is this your first dog? Yes No How did you hear about Canine Revival? YOUR DOG'S HEALTH: Does your dog have any known allergies? Yes No If so, to what food(s)? Does your dog have any health problems we should be aware of? Yes No If so, please list any health problems: Is your dog on any medication? Yes No If so, please list medications: Has your dog had any gastrointestinal (GI) problems in the past? Yes No If so, what was the cause (if known)? YOUR DOG'S INFO: Your Dog's Age Age at Adoption Breed (or best guess): Where did you adopt your dog? Please share anything you know about your dog's history prior to you adopting him/her. Sex Male Female Is your dog spayed/neutered? Yes No If so, what age? Describe your dog's energy level (couch potato, average, high energy, etc.): Do you feel your dog's energy level matches your own and/or other family members Yes No Do you ever use interactive food toys/balls/puzzles/bowls to feed or treat your dog? Yes No If using these, what kind? How often do you exercise your dog? (If your dog is too young, how often do you plan to do so?) What type of exercise does your dog engage in? (if your dog is too young, what are you planning?) Do you, or will you take your dog to a Dog Park? Yes No Do you, or will you take your dog to Dog Day Care? Yes No How does your dog typically respond to meeting a new dog Has your dog ever nipped/bitten another dog? Yes No How does your dog typically respond to meeting a new person? Has your dog ever nipped/bitten a person? Yes No TRAINING: Has your dog had any previous training? Yes No If so, where and by whom was the training done? What, if any, commands / tricks does your dog already know? What specific things would you like to address with training? Are you interested in participating in any sports with your dog? Yes No If so, which sports? Are you interested in working toward a Canine Good Citizen (CGC) or Therapy Dog test? Yes No If so, which one? YOUR DOG AT HOME: Is your dog housebroken? Yes No If so, what clue does your dog give you to go outside or do you use a schedule? How do you contain/restrain your dog outside? Is your dog crate trained? Yes No When no one is home, where is your dog? When someone is home, where is your dog? On average, what is the length of time your dog is left alone daily? Where does your dog sleep at night? Does your dog sleep through the night? Yes No Do you use a collar or harness when walking your dog? Collar Harness What kind of leash do you use? Does your dog walk nicely on a leash? Yes No Does your dog wait at the door when opened, or are you worried he/she may bolt out? Is your dog good at greeting visitors and if not, what does he/she do? Does your dog come when you call him/her? Yes No Is your dog good when riding in the car? Yes No When riding in the car, what type of restraint do you use for your dog? Is your dog allowed on furniture? Yes No Is your dog allowed on human beds? Yes No What type of toys does your dog play with? Do you consider your dog to be food motivated? Yes No How many times do you feed your dog daily? What type of food does your dog eat? Do you leave your dog's food out all day or have set meal times? Where do you feed your dog? Do you feed your dog "people food"? Yes No ABOUT YOU / YOUR FAMILY: Do you have any other pets at home? Yes No If yes, what other pets do you have? How many people live in your house? Number of Adults Number of children under age 18 Your Telephone OK to text to this number? Yes No Your Address including City and Zip In general, what are your preferred days for training sessions? Your preferred appointment times? Do you prefer in-home training, training at Canine Revival, or a combination of both? Is there anything else you'd like us to know? Send
