New Client Request Form Name * First Name Last Name Email * Phone * (###) ### #### Postcode * (###) ### #### Which service are you interested in? * In home Zoom Combination of both Dog's Name, Gender, Age, DOB, & Breed/s? * Dog's Colour, Markings, & Size? * Is your dog desexed? If so at what age? * How long have you had this dog? * Where did you obtain this dog? * Shelter adoption Rescue adoption Friend or Family Gumtree, Newspaper, Facebook, other ad?? Breeder Pet Store Other What previous environment did this dog come from? * Apartment Unit/Townhouse House with fenced yard Rural/Acreage Shelter Other What environment is this dog living in now? * Apartment Unit/Townhouse House with fenced yard Rural/Acreage Do you have other adults/children living in the home? Provide details. * Do you have other dogs/animals living in the home? Provide details. * Who is your dog? Describe their personality. * What does the dog most enjoy, and how often does your dog do that? * How does your dog spend her/his days and evenings? * Describe any enrichment opportunities you provide for your dog. * How many hours out of 24 are they home alone? * When your dog is left home alone, what are they doing during this time? * How many hours on average would your dog sleep out of 24? * Where does he/she sleep (e.g bedroom, couch, own bed, crate, garage, kitchen, laundry room, yard, etc) * Please describe the behaviour/s of concern. * Have any behaviours of concern started just recently? If no, when did they begin? * So far, how do you let your dog know what behaviour you want and how have you addressed undesired behaviour? * Has your dog ever bitten, tried to bite, lunged at, growled, or behaved aggressively toward any person or animal? If yes, please state which of these and the context it happened. * Has the dog ever cowered, trembled, 'frozen,' attempted to avoid you or others, or seemed oddly uncomfortable? If yes, please state which of these * Have there been any sudden or recent changes in the dog's life / environment? * Have there been any recent changes in health or any recent injuries? Please provide details. * When was the dog's last vet visit, and for what? * What kind and quantity of food does your dog eat for meals, and how often? * What medications is the dog on currently and/or what medications has the dog had within the six months or so? * What do you feel is the FIRST/MOST IMPORTANT thing that you and your dog need help with? * What are you expectations about the dog training and behaviour change process? * How did you hear about us? * Do you wish to receive my (very irregular) client newsletter? * Yes No Thank you for reaching out! Please bear with me whilst I do my best to respond to enquires from prospective new clients in a timely manner whilst properly serving my current clients. I look forward to working with you and your dog.