Client & Dog Information

Name *

First

Last

Email *

Home Phone

Work Phone

Cell Phone

How did you hear about us?

Dog's Name *

Dog's Breed/Age/Sex *

Date of Adoption

Most recent vet visit and results

Dog's Routine

Describe your dog's daily routine

What does the dog do for exercise, and how often and for how long?

What does the dog do when you're gone from the house?

What kinds of toys, chews, etc. does the dog play with, and how often? When does he/she play with his/her toys?

Training History/Reinforcers

Have you done any training with the dog, or had he/she done any before you adopted him/her? Where did you do the training? Can you describe the basic approach you learned to train your dog? Did you feel you got the results you were looking for?

What are you dog's favorite foods or treats?

What are your dog's favorite toys?

What are your dog's favorite activities?

Client's Goals

What would you like your dog to do?

What would you like to be able to do with your dog?

Behavior Intake Form

Client & Dog Information

Dog's Routine

Training History/Reinforcers

Client's Goals