Dog Training Questionnaire

*Please note that this questionnaire needs to be filled out prior to an appointment being scheduled*

Client Information
Client Name*
First Last
Date
Date Format: MM slash DD slash YYYY
Address*
Street Address Address Line 2 City ZIP Code
Email
Phone*
Pet Information
Dog's Name*
First
Breed*
Date of Birth/Age*
Male/Female?*
Spayed/Neutered?*
Where did you get your dog?*
Why did you choose this particular dog breed?
Have you owned this breed before?
Is your dog currently on any medications*
If yes, please list:*
Are you aware of any negative experiences your dog has had that could contribute to their behavior?*
If yes, please describe:*
Training Information
Has your dog had any prior training experience?*
If yes, where:*
Describe the current commands your dog knows:*
How many people in your household handle your dog for veterinary appointments?
Who in your household will be responsible for your dog’s training?
What are your dog’s favorite treats?
What training tool do you use to walk your dog?*
If other, what do you use:*
What is the primary reason for seeking the help of a trainer? List 3 things in order of importance:*
What would you like your dog to do instead of the behaviors listed above?*
Are you having any specific issues with any of the following:*
Dog’s Specific Preferences/Personality Spectrum
How does your dog respond to unfamiliar people in public settings?*
Does your dog have any noise sensitivities? If yes, please list them:*
Can family members or veterinary staff complete nail trims on your dog? If not, why?*
Can family members handle the dog by the collar?*
Can veterinary staff safely handle the dog by the collar?*
Does your dog have any specific fears or OCD type behaviors you are aware of?*
If yes, please explain:*
Dog’s Daily Routine
On average, how many hours a day is your dog alone?*
What type of exercise does your dog receive?*
What is your dog’s favorite activity?*
Public Manners Questions
How does your dog behave on a leash in public places?*
How does your dog respond to people or other dogs on leash?*
Are you comfortable with the walking tool you are currently using to walk your dog?*
Do you feel you have proper control over you dog’s behavior when on a leash?*
Explain
Are there any undesirable leash behaviors you would like to address?*
Specific Veterinary Exam/Behavioral Questions
Does your dog feel comfortable with restrain/handling by veterinary staff?*
Is there any specific exams/procedures your dog does not respond well to?*
Is your dog comfortable enough to willingly step on the scale?*
Anxiety/Aggression/Fear Behavior Questions
Does your dog display any anxiety, fear, or aggressive behavior in the lobby or during exams? Explain:*
Does your dog display anxious behavior in the car/parking lot before they come in? Explain*
Does your dog display any anxiety, fear, or aggressive behavior outside of the veterinary setting? Explain:*
When your dog displays any of these behaviors, what is your response? What action do you take to mitigate the behavior?*

Your Veterinarian in Middletown, PA

Your Other Family Doctor

Our Location

2164 East Harrisburg Pike
Middletown, Pennsylvania, 17057

Contact

Phone: 717-944-5863
Fax: 717-944-2838
Email: info@londonderryvet.com

Hours

Sun: Closed
Mon: 7:30 am – 5:00pm
Tue: 7:30 am – 5:00 pm
Wed: 7:30 am – 5:00 pm
Thur: 7:30 am – 5:00 pm
Fri: 7:30 am – 5:00 pm
Sat: Closed

Dog Training Questionnaire

Client Information

Pet Information

Training Information

Dog’s Specific Preferences/Personality Spectrum

Dog’s Daily Routine

Public Manners Questions

Specific Veterinary Exam/Behavioral Questions

Anxiety/Aggression/Fear Behavior Questions

Your Veterinarian in Middletown, PA

Your Other Family Doctor

Our Location

Contact

Hours

Find Us on Facebook

Meet Our Team

Visit Our Online Store