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. Once this form and your unique situation is reviewed, we will call you to discuss your training needs. In the event that we can't get in touch with you via phone call, we will e-mail you instead.