INTAKE QUESTIONNAIRE

HUMAN'S NAME (first and last)

PHONE

ADDRESS (including city and prov.)

DOG'S NAME

DOG'S AGE AND BREED

AVAILBILITY?

WEEKDAY EVENINGS

WEEKEND

WHEN DID YOU WANT TO START?

FIRST NAME AND AGES OF OTHER HOUSEHOLD MEMBERS

NAMES, SPECIES AND AGES OF OTHER HOUSEHOLD PETS

WHAT ISSUES DID YOU WANT TO ADDRESS IN TRAINING?

WHAT IS YOUR PAST TRAINING HISTORY?

WHAT HAVE YOU BEEN ATTEMPTING TO MITIGATE THE PROBLEM BEHAVIOUR?

WHAT DO YOU USE TO WALK YOUR DOG? (harness, collar, etc.)

IS YOU DOG ON ANY MEDICATION OR SUPPLEMENTS?

DOES YOU DOG HAVE ANY MEDICAL CONDITIONS WE NEED TO TAKE INTO ACCOUNT?

DOES YOUR DOG HAVE A BITE HISTORY WITH PEOPLE, DOGS OR OTHER ANIMALS? IF SO, WHAT ARE THE CIRCUMSTANCES?

WHERE DOES YOUR DOG SLEEP? WHAT BRAND OF FOOD DO THEY EAT? WOULD YOU SAY THEY ARE ADEQUATELY EXERCISED PHYSICALLY?

ANYTHING ELSE YOU THINK WE SHOULD KNOW?

Thank you! We’ll be in touch.

WiggleBums wigglebums@protonmail.com