KissAble Canine Behavior Intake Form

Please complete this form and submit it prior to your initial session with the trainer so we are better prepared to assist you. We use this information to understand your dog's background and daily life.

If completing this form for more than one dog, place a "/" between answers.

Questions? Call 703-574-3383 or email info@kissablecanine.com

Date:

Full Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

For private lessons: Where will the trainer safely park when conducting a lesson?

Home Phone Number

Area CodePhone Number

Work Phone Number

Area CodePhone Number

Mobile Phone Number

Area CodePhone Number

E-mail

How did you hear of KissAble Canine?

Family Members

If children, what are the ages

Dog's Name

Dog's Birth Date

MonthDayYear

Gender

Sex Status

Breed(s)

Where did you get your dog?

How long have you had your dog?

Veterinarian's business name

What food brand does your dog eat?

Does your dog eat fast?

What treats do you give your dog?

Is your dog on any medication?

Does your dog have any physical ailments?

What is your dog's daily exercise routine?

Do you use or have you used an electronic fence for your dog(s)?

Do you have any other dogs in the household?

If Yes, please list other dogs' name and ages:

What are the unwanted behaviors/bad habits that you want to change? Please list in order of priority.

When did you first observe them?

What have you done to train or stop the behaviors?

Have you seen other trainers/behaviorists before?

Where does your dog sleep?

When you are gone during the day where does your dog stay?

Does your dog play with other dogs on or off-leash?

How does your dog react to strangers in the house or outside?

What commands does your dog know?

Has your dog ever been in a fight?

Does your dog bark? If so, what does it bark at?

Does your dog allow removal of chews, toys or the food bowl?

Does your dog play keep away with toys, food or other items?

Have you ever seen your dog bite, snap, nip or put his teeth on a person?

What are your training expectations of this dog?

Anything else you would like to tell us about your dog?

Please list your general availability to meet with a trainer:

KissAble Canine sends a quarterly newsletter that shares training tips, events and news. May we include your email address:

Behavior Intake Form

Owner Information

Dog's Information