Client Interview

Is your dog up to date on their vaccinations and can you provide proof of that? *

Why did you select this particular dog or breed? *

Age and/or Physical disabilities *

Not a legal adult Adult age with no physical issues I have physical handling issue due to age, injury, or sickness

Please detail any issues that may make training hard for you to participate in. *

What has been your ownership history with dogs to date? *

How many days per week are you willing to train your dog? *

How much time per day are you willing to train your dog? *

Does your dog require house training? *

Yes No Is inconsistent at home Not sure if house trained other places than home

What has been your history to date of training dogs? *

Have your previous dog training results been satisfactory to you? *

Yes No Not Applicable

If you have participated in dog training in the past but not finished, please explain why. *

Please describe goals for training your dog. *

Please describe interactions your dog or dogs have with adult family members, friends, or other adult. *

Please describe the exposure or interactions your dog or dogs have with children. *

Please list the household family members interacting with your dog(s) now. *

List any and all aggressive interactions your dog or dogs have had with adults and children. *

List any and all aggressive interactions your dog or dogs have had with other dogs. *

List and describe any and all behavioral problems that you have observed in your dog(s) *

Please describe any reactiveness you have seen between your dog or dogs and strange dogs and/or humans. *

Does your dog have anxiety or fear issues? *

Not at all Occasionally in unfamiliar situations My dog is fearful of everything

Have you received any professional training help with your current dog or dogs referenced in this questionaire? *

Please describe the frequency of leashed walks, unleashed exercise or dog sports that your dog(s) are currently involved in. *

Please describe the socialization and family activity experiences that your dog or dogs have experienced to date. (ie vacations, hikes, parks visited, strange houses visited, or commercial retail stores visited). *

What type of environment does your dog or dogs live in (ie house, apartment, outside, kennel)? *

What items has your dog destroyed inside or outside your house? *

Which service are you most interested in? *

K911 Board and Train Program Pack Learning Day Train Program Private Weekly Lessons

What days and times are best for you to take lessons or leave your dog wiith us? *

If you were referred by someone, please let us know who. *

Would you like our newsletter sent to you? *

Yes No

Please fill out the following form completely. We will use this to plan your training experience.