Private Training Form DateNameCell PhoneAddressEmailWhere did you hear about One Smart Dog Training?What type of training are you interested in?What is your availability?MondayAMPMAMPMTuesdayAMPMAMPMWednesdayAMPMAMPMThursdayAMPMAMPMFridayAMPMAMPMSaturdayAMPMAMPMPlease describe your dog’s previous training taken with us or elsewhere (If Any)1.Do you crate your dog?YesNo2.Do you have a separate room or place for your dog?YesNo3.Do you tie your dog outside?YesNo4.Do you have an outside kennel/run for your dog?YesNo5.Where does your dog sleep at night?6. If on a couch or bed, will your dog vacate the spot at your request?YesNo7.Is your dog spayed/neutered?YesNo8.Are your dog’s vaccinations up to date?YesNo9.Are there other dogs in the home?YesNoIf so, list:10.Can your dog be safely left alone in your house?YesNo11.Can your dog be safely left alone in your car?YesNo12.Are there situations when your dog appears stressed?YesNoIf so, describe:13.Have you taken your dog to any training classes?YesNoIf so, describe type of class and with whom:14. Does your dog easily comply with a request to give up anything in his/her possession?YesNo15.Can your dog be petted, moved, or interrupted while eating?YesNo16.If given a treat, does your dog take it gently?YesNo17.Can all family members expect reasonable compliance to reasonable requests?YesNo18.Is there a family member that your dog disregards or ignores?YesNoso, who?19.When guests arrive is your dog out of control?YesNoWhat does your dog do?20.When at the vet’s office will your dog allow itself to be restrained and/or examined without struggling, growling, or biting?YesNo21.When you encounter other dogs is your dog out of control?YesNoWhat does your dog do?22.What are the situations that cause your dog to growl? What actions do you take?23.Has your dog ever bitten a person?YesNoIf yes, how many times:Describe the bite:Just cause a bruise?Break the skin?Stitches needed?24.Has your dog been in a dogfight with another dog?YesNoCheck all that apply: Neither dog got hurt My dog had a few cuts My dog had at least one puncture wound My dog needed stitches The other dog had a few cuts The other dog had at least one puncture wound The other dog needed stitches 25.Are there situations in which you feel you have little or no control over your dog?YesNoIf so, describe:26.Has your dog ever been on a choke, pinch, or shock collar?YesNoIf yes, how long?27.Is your dog contained by any electronic fencing system?YesNoIf yes, how long?28.Is food left out continually for your dog?YesNo29.Last visit with a vet?Name of vet:30.Any health problems?If so, describe:Any medications?If so, list:31.What do you feed your dog? How much per day?32. What are your goals for your dog?33. Is there anything else you would like me to know about your dog?My dog has problems with: Men Men with (hats, beards, sunglasses, other: ) Women Kids (Ages: ) Mail or UPS Person Groups of people People walking People coming up from behind People running/jogging People on the other side of a fence or barrier Moving body parts (i.e. someone swinging their arms) Eye contact from strangers My dog has problems with other dogs when they: Being petted or touched Make direct eye contact Run Approaching head on Approaching fast My dog has problems with the following inanimate objects: Coats Hats Sunglasses Gloves Boots Umbrellas Stuffed animals Papers blowing in the wind Playground equipment Drainpipes Trucks Manhole covers Water (bath/lake/river/rain) Gravel Pots and pans dropping Loud music Shopping carts Thunder Walk Play stand still approach the crate approach the car approach the yard approach the home Sniff my dog’s rear Are on leash Are off leash Puppies Male dogs (Intact or neutered) Female dogs (intact or spayed) Certain Breeds of dogs: Other: Please Specify
