*Owner's First Name:

Please enter your First Name

Owner's Middle Initial:

Please enter your Middle Initial

*Owner's Last Name:

Please enter you Last Name

*E-mail Address:

Please enter you E-mail Address

*Phone Number:

- -	Please enter your Phone Number (in case we need to contact you)

*Mailing Address:

Please enter your Address

Mailing Address cont.:

*City:

Please enter your City

*State:

Please select your State

*Zip Code:

Please enter your Zip Code

History (For multiple dogs, use separate forms)

Dog's Name:

Please enter your Dog's Name

Dog's Age:

Please enter your Dog's Age

Age Obtained:

Please enter the Dog's Age when you obtained it

Breed(s):

Please enter the Breed(s)

Male/Female:

please select Male/Female

Neutered/Spayed:

Please select if your dog is Neutered/Spayed

What age was your Dog Neutered/Spayed:

Please enter the age your Dog was Neutered/Spayed

Intact? Why?:

Please enter why your Dog is un-neutered/un-spayed

Where did you get your dog from?:

Please enter where you got your dog from

Household

Family members/ Children's ages:

(chars left: 400)

Please enter family members/ children's ages

Other Pets: Where does this dog come into play (first dog, latest dog)?:

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Where does this dog come into play (first dog, latest dog)?

What was it about this dog that you liked?:

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Please enter what was it about this dog that you liked

Where does your dog sleep?:

Please tell us where your dog normally sleeps

Diet

Type of Food:

Please select type of food

Food Brand:

Please select the Food Brand

Raw/BARF (What does this consist of?):

Please type what does Raw/Barf consist of

Home Cooked (What does this consist of?):

Please enter what home cooked consist of

Supplements:

Tell us what supplements (if any) you give your dog

Enticements to Eat:

Please tell us if you have to give your dog any enticements to eat

Treats:

Tell us what treats you give your dog

How many times have you switched foods in the last year?:

Tell us how many times you have switched foods in the last year

Past Choices:

Tell us your past food choices

How are they fed:

Tell us how many times a day you feed your dog

Quantity of Food:

Tell us how much your dog likes to eat

Appearance

How much does your Dog weigh:

Tell us your dog's weight

Your dog's optimum weight:

Tell us your dog's optimum weight

How does your dog look?:

Select one or more

Medical Problems:

Tell us any Medical Problems your dog may have

Medications:

Tell us any Medications your dog takes

Last Vet Visit:

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Tell us your dog's last Vet Visit & what was your visit for

Last Inoculation:

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Tell us your dog's last Inoculation & what it was for

Reactions to inoculations?:

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Tell us if your dog has any reactions to inoculations

Lifestyle

How are they on a leash?:

Select how your dog is on a leash

Equipment:

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Tells us of any Equipment choices

Exercise (How often?):

Tell us your dog's exersise routines

Any Physical Limitations?:

Tell us if your dog has any physical limitations

Previous Training:

Please select one or more

What does your dog LOVE?:

(chars left: 500)

Tell us what your dog loves

What does your dog dislike?:

(chars left: 500)

Tell us what your dog dislikes

Personality

Applies to my dog:

Doesn't apply:

Applies to my dog:

ADD all that apply!

Add a few of your own:

Aggression (AKA The Big Enchilada)

Do they have specific triggers to aggression? :

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For eample they don't like guys in hats or black female dogs

Do they have any handling issues?:

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Touch my tail and DIE sucka!

When they see or hear something that makes them react do they:

Select how your dog reacts

. What happens on their body?:

For example the fur stands up all down their backs, etc

How quickly do the recover from stress?:

Tell us how your dog recovers from stress

Has your dog ever been in a dog fight whether or not they started it?:

Tell us if your dog has ever been in a dog fight

Ages of incidents:

(chars left: 400)

4-5months / 9-12 months / 15-18 months / 3years Or Your dog's timeline: How many instances?

Blood Shed or Bluster? :

Tell us about the aftermath of the fight

Has your dog ever growled at:

Select one or more

Has your dog ever tried to bite:

Select one or more

Has your dog ever bitten:

Select one or more

Has your dog ever redirected their aggression onto you or others near by?:

Select yes or no

Do they target:

Select who they target

Bite Level:

Select one or more

Is your dog possessive of:

Select one or more

Are you afraid of your dog?:

Select one

BEHAVIOR CONSULTATION FORM (PRE-REGISTRATION)

History (For multiple dogs, use separate forms)

Household

Diet

Appearance

Lifestyle

Personality

Aggression (AKA The Big Enchilada)

Other Behavior Problems


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