Pawswise Client Questionnaire The questions are below. Please give as much detail as you can, describing what you can actually see, rather than what you think, believe or suspect your dog is thinking/feeling. This is an important difference at this time. It is particularly important when you reach the questions that ask you to describe how your dog responds or acts under specific circumstances. The best way to return them to me is to type in your answers, save and attach to an email to the address at the end of this form. Thanks in advance for your work on this. 1. Name and age groups (teen, adult, over 70, etc.) who live with you or are frequent/regular visitors. 2. Your first and last name. 3. All pertinent phone numbers and best times to call. 4. All "vital statistics" on your dog, name, breed/mix, age, neutered, spayed, etc. 5. Where did you get this dog, when and how old was he? 6. How did you happen to pick this particular dog, not just the breed, but this individual? 7. Are there any other animals in your house and if so, what and how old are they? 8. How long have they been with you? 9. How would you describe this dog's behavior around them?
10. Have you taken this dog to any classes or worked with other trainers? Yes No If yes, please describe your general goals, the methods used and the results. 11. Has your dog had any serious illnesses or injuries? 12. Does he have any food allergies or sensitivities which might limit the type of food treats we use? Yes No If yes to either, please describe. 13. Who is your vet? 14. Is your dog house trained and crate trained? Yes No If yes, were there any problems with either and if so, please describe them. 15. Where does your dog stay when you are gone? 16. About how many hours a day is he typically alone? 17. What is the longest he might be alone and how often does that happen? 18. What does he have to do while you are gone? 19. What do you think he does while you are gone?
20. Where does he generally hang out when you are home? 21. Is he allowed on the furniture? Yes No If yes, will he get off politely and with reasonable promptness if asked? 22. Where does he sleep at night? 23. What basic behaviors (sit, down, stay, leave it, etc.) do you want your dog to perform reliably? In general, 80% or more is considered reliable by most professionals. At this point, which behaviors does your dog perform reliably in your back or front yard, with slight distractions (not a rabbit running under his nose!) 24. How well, on a scale of 1 to 10, with 10 being fabulous, :-) does your dog pay attention to you at this time in public? 25. What behaviors are you most concerned about at this time? Please list all you can think of and provide as much detail as possible. This may be behaviors we had not discussed over the phone. 26. When did these behaviors begin? Were there any changes in your dog's life at this time, such as a new residence, change in household inhabitants, being charged/bitten by another dog, scared by a person, a series of vet visits, etc.? 27. Has this dog ever bitten a human except in play? Yes No
If yes, please describe in detail what happened just before and after the incident and the reactions of humans in the immediate vicinity. How did people react to the dog? What did your dog do immediately after the incident? Can you describe the location, depth and appearance of the bite? Was medical attention needed? Please answer these questions for all bites and also note whether this dog did or does bite roughly in play and if so, how you respond to it. Please answer the following questions if your dog has bitten another dog. 28. Does your dog growl/snap at people or other dogs? Yes No If yes, please describe as in #27. 29. Does your dog "guard" food, toys, and/or its place on the couch or you from other dogs or people? Yes No If yes, please describe. How have you responded to it?
30. What does your dog do under the following circumstances? a. Adult (known) visitor comes to your home? b. Adult (unfamiliar) visitor comes to your home? c. Familiar children/teens come to your home? d. Unfamiliar children/teens come to your home? e. Adult passes him in public? f. Adult wants to pet him? g. Child passes him in public? h. Child wants to pet him? 31. What does your dog do when he sees another dog on leash while he is on leash? 32. If your dog is off leash?
33. If the other dog is off leash? 34. What does your dog do as you are preparing to leave? 35. When you return home? 36. What is your dog's behavior at the vet? 37. If applicable, at the groomer's? 38. Who feeds your dog? 39. When, what, and where? 40. Does your dog get treats? Yes No If so, from whom, when and why? 41. How much exercise does your dog get and what kind? (walks, chasing a ball, daycare, etc.) 42. Does your dog go for walks and if so, what kind of collar or harness and leash do you use? 43. Does he pull? Yes No
44. About how much time among all family members is spent during the week with your dog? This may include walks, snuggling on the couch, playing games, going for rides, training, etc. 45. About how much time a month is spent training your dog, actually working on specific exercises or rewarding/correcting him for various behaviors? 46. What have you tried to change your dog's unwanted behaviors? (All, not just the ones we discussed) 47. How effective have they been in making a lasting change? 48. If you have used such methods such as yelling and loud voice, water bottles, collar jerks, "alpha rolls" etc., how effective have these things been in making a lasting change in the behavior and what is your dog's immediate response? Please describe his behavior and expression. 49. What does your dog do when he sees other dogs/people or a combination of them from: The yard The house The car
50. Does your dog appear to enjoy car rides? Yes No 51. Where does he ride in the car? 52. Does he whine, pace or try to get into your lap? Yes No 53. What does your dog do when he sees things such as rollerbladers, strollers, motorcycles and bikes? 54. Do the sudden movements of people or other dogs seem to elicit any particular behaviors? 55. Does your dog have any fears that you know of, such as loud noises of any kind, flapping bags, brooms, etc.? 56. Is there anything else I should know about your dog before we meet? Finally, it is important to me that our training is successful. So that I can better design management and training plans for you and your family, please consider the following and have each adult give their input. On a scale of 1 to 5, with 5 being "Extremely Important," how important is it to you that your dog change his/her problem behaviors?
Life is busy! Realistically, how many hours a week can you find to work with your dog? This may include regular training sessions at home, taking your dog different places for walks, longer walks, etc. How willing are you to change your schedule to find time to follow up with training? This may mean that you give up, reprioritize or change the order of certain activities for a while, for training. Thanks so much for your hard work on this! Harline Harline Larkey M. Ed., C.E.M. T II PawsWise Dog Training APDT #74345, CGC & STAR Puppy Evaluator #38782 Livermore, Colorado 970-493-2016 dogtrain@pawswise.com www.pawswise.com