_________________________Age ________ Sex M F
Birth date ____________________________
What age was your dog when you got him/her? _________________
Did you get from breeder, rescue, shelter, pet store, other?
Number of people in household. Adults _______ Children ________
Does your dog like children? Y N
Please describe how your dog behaves around children
Do you have other pets? Y N If
yes, how does the dog get along with the other pets in
Has your dog had any obedience training? If so where and what kind?
If no obedience training what
commands do you use at home?
Where does your dog sleep at
What brand of dog food do you feed your dog?
What is your feeding schedule? ________________________________________
Health and Grooming
Does your dog have any health
problems? Y N
Please describe _____________________________________________________
Does your dog have any allergies? ______________________________________
Are there any sensitive areas on your dog's body?
How does your dog behave when
someone takes a toy or food away?
When a stranger comes to your door, what happens?
What are some of the things your dog is afraid of?
Has your dog ever growled or bitten anyone? Y N
Does your dog jump fences? Y N
Are there any behaviors that
annoy you, or you would like to change? Y N