Training Profile Name * Name First First Last Last Address * City and Zip * Phone * Email * Emergency Contact * Emergency Contact First First Last Last Relationship * Phone * Dog’s Name * Dog’s Breed/Mix * Dog's Age * Gender * Male Female Is the dog spayed or neutered * Yes No What Age? * Was it due to a behavioral problem? Explain. * Age of dog when acquired: * How long have you had the dog? * Where did you get your dog? * Vet's Name * Vet's Name First First Last Last Phone * Is your dog up to date on vaccines? DHLPP, Rabies and Bordetella * Yes No Does the dog have any physical limitations/medical problems or food allergies? If yes, explain. * Is your dog on any medications? If yes, explain and list medication. * Does HANDLER have any physical limitations? Explain. * List all people living in the house, including yourself. Name, Age and Relationship to you: * Are there other pets in the house? If so, what kind, breed, gender (neutered or spayed?). * Does the dog “belong to” a particular household member, or everyone? * Do any household members dislike the dog? If so, why? * Are any household members frightened of the dog? If so, why? * Is the dog frightened of any of the household members? If so, who and why? * Where did you acquire your dog? Breeder, Shelter, Pet Shop or Other? Explain if Other: * How long does the dog spend without humans? * With humans? * Is the dog crate trained? * Yes No What type of exercise does the dog get? How long and often? (If none, please note reason). * Who normally exercises and trains the dog? * What type of collar and leash is being used? Ex: buckle collar, head halter, body harness. * Does the dog ever become reactive towards other dogs or people? If yes, explain. * Have you ever taken other training classes? If so, where. * Check the behaviors that apply to your dog: * Aggressive (describe below) Pulls on leash Guards food/toys/possessions/other Jumps on People Darts outdoors/gates Threatening/growls at other animals Mouthing/Nipping Fearful (describe below) Threatening/biting family / Strangers Potties in the house Steals food/trash/objects Chews furniture/shoes/etc. Urinates when excited Excessive attention seeking Anxious when alone Destructive when alone Digs in yard Escapes from yard Grabby with treats Understands but won’t obey Excessive vocalization when alone / when you’re home Other (describe) * List any procedures/training/training equipment you’ve used to try to correct the behaviors circled above: * Has your dog ever bitten anyone? * Yes No Any animals? * Yes No If so, please describe in as much detail as possible: * Has medical attention been necessary (for human or animal) because of any aggressive incident? * Yes No If yes, please explain: * Is there any other information you feel is important for us to know? * Email If you are human, leave this field blank. Submit
