0477 289 647

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Dog Behaviour Form

To get the most out of my service it would help to have some background on your dog. Please complete the form below or if you prefer, print out this PDF version and email to me here.

Step 1 of 7

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You and Your Family Details
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email*
Mobile Phone*
Home Phone
Most convenient way of contact*
- SMS
- Email
- Mobile Phone
- Home Phone
Number of adults in your home
Number of children in the home
Ages of children in the home or who regularly visit
Does your dog behave differently with different family members?
- Yes
- No
Any other pets?

Dog's Details
Name
Age
How long have you had the dog?
Breed
Sex
- Male
- Female
Desexed?
- Yes
- No
Desexed at what age?
Size
- Small
- Medium
- Large
Where did you get the dog?
- Breeder
- Pet Shop
- Shelter/Welfare
- Pound
- Stray
How old was the dog when you acquired it?
Has your dog had any previous owners?
Why did you choose this breed?
Have you owned dogs before?
- Yes
- No
What type?
Has the dog been to any formal training programmes?
- Yes
- No
How long did the program run for?
Who conducted the training?

Exercise and Play Routine
How much time do you spend with your dog each day, (playing, exercising, or just being together)?
What toys does your dog like to play with?
What type of exercise does your dog receive, how often, and for how long? i.e. on lead walking, off lead at the beach, playing games at home for an hour every day, etc

Home Environment
Does the owner live in?
- Acreage
- House with a large yard
- House with a small yard
- Town house
- Unit
What % of the day is the dog inside?
What % of the day is the dog outside?
What % of the day is the dog crated?
What % of the day is the dog elsewhere?
Is your dog allowed on furniture?
- Yes
- No
Where does your dog sleep at night?
Where is your dog when nobody is home?
How much time does your dog spend alone?
What is your dog’s reaction when you return home?
Is your dog toilet trained?
- Yes
- No
Eating Habits
What do you feed your dog?
If dog food - what brand?
When do you feed your dog?
Does your dog finish his meal? Always - sometimes - never?
Do you consider your dog to be greedy/normal appetite?

Describe Your Dog's Response to the Following
Familiar dogs
Unfamiliar dogs
Familiar people
Unfamiliar people
Children
Moving objects
Loud noises
Machinery
Walking on a lead
Does your dog like toys? If so, what kind?
Does your dog have continuous access to toys?
- Yes
- No
How much is your dog motivated by food? 1=low/10=high
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
Is your dog happy to be left alone?
- Yes
- No

Medical History
Does your dog have current health problems?*
- Yes
- No
Does your dog have any pre-existing medical conditions?*
- Yes
- No
Is your dog currently on any medication?*
- Yes
- No
Does your dog have any allergies e.g. food/plants?*
- Yes
- No
Who is your dog's regular vet?
Vet's phone number

Behaviour Problem
Describe the behaviour problem in detail
What is the issue?
How often does the issue occur?
Has the behaviour got worse? If so, why?
Do you have any explanation as to the cause of the problem?
When did the dog first start the behaviour?
When was the most recent incident?
Has the frequency of the behaviour changed?
What have you tried so far to correct the problem?
Any other behaviour problems?
Does your dog ever growl at you or another member of the family?
Why have you decided to ask for help now?

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I'm all your dog needs!

For Central Coast Dog Training, Dog Walking, Pet Sitting and Dog Boarding. From Terrigal to Tumbi Umbi, Wamberal to Wagstaffe, Erina to The Entrance, Holgate to Hardy’s Bay, McMasters to Matcham, Killcare to Kangy Angy, Springfield to Shelley Beach, Lisarow to Long Jetty, Gosford to Green Point.

About Me

My name is Anne and I’m Nuts about Mutts! I am a passionate and qualified dog trainer, dog walker and pet sitter located on the Central Coast of NSW. Read More

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Central Coast Dog Trainer
Central Coast Dog Walker
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Dog Behaviour Form
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P: 0477 289 647
E: Email me here

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