Dog Training in Gainesville – NEW CLIENT INTAKE/BEHAVIOR FORM

STEP 1.
FILL OUT NEW CLIENT INTAKE/BEHAVIOR FORM
Please describe the problematic behavior(s) or concerns you are having with your dog(s), and your treatment goals, in as much detail as possible. History includes known history before you got your dog(s) and any incidents/events since you got them.

*** AGGRESSION/BITE CASES*** For cases dealing with aggression that involve ANY bite incidents, you MUST fill out the BITE INCIDENT(S) section below with as much detail as possible (ie. describe incident, possible trigger, severity of bite, bruise, puncture, tear, stitches, was bite recorded/charged, etc.) so we are able to plan accordingly. We will work with an aggressive/biting dog, but we have to have a very clear idea of what we are dealing with before we begin working with them.

NEW CLIENT INTAKE/BEHAVIOR FORM

TODAY'S DATE:
* Indicates required field.
First Name:* Last Name:*
Email:* Phone:*

Please tell me about your dog(s). If more than four please add into the history notes field below.
DOGS NAME:
Age: Sex: Breed:
DOGS NAME:
Age: Sex: Breed:
DOGS NAME:
Age: Sex: Breed:
DOGS NAME:
Age: Sex: Breed:
HISTORY:
Please tell us a little about known history of your dog(s):

REASON(S) FOR CONSULT:
IN ORDER OF IMPORTANCE- Please tell us a little about the problems/concerns you are having with your dog(s), the reason(s) for your consult. :

***BITE INCIDENTS:
Please tell us about ANY/ALL known bite history or bite incidents involving your dog(s) Please describe the incident, possible trigger(s), severity of bite (bruise, puncture, tear, stitches), was bite recorded/charged, etc):

MEDICAL HISTORY:
Please tell us about ANY/ALL known significant medical history or current medical issues with your dog(s):

Please indicate preferred method of contact: (optional)
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