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TRAIN WITH SARA
Canine Questionnaire
Nick Ondrako
2022-08-02T17:35:53-04:00
Canine Questionnaire
This form helps me get a better understanding of your needs.
Step
1
of
7
14%
Canine's Name
Breed
Age
*
Sex
Female (Intact)
Female (Spayed)
Male (Intact)
Male (Neutered)
Name
First
Last
Phone
*
Email
*
Address
*
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
How did you hear about Sara?
What is the Primary Goal of Training/Behavior Modification?
Neutered Behavior Changes
Veterinary Hospital
Veterinarian Phone
Name of Veterinarian
Does your dog have any known health issues?
Yes
No
Health Issues
Is your dog currently on any medications?
Yes
No
Medications
Please list the dates the following vaccines were last given
Canine Rabies Vaccine
MM slash DD slash YYYY
Distemper Parvo
MM slash DD slash YYYY
Canine Bordatella
MM slash DD slash YYYY
Do you have other animals in the home?
Yes
No
Other Animals
Other Animals Issues
Do you have other humans in the home?
Yes
No
Please list other humans living in the home
Relationship with Humans
How many times a day do you feed your dog?
One Meal A Day
Two Meals A Day
Three Meals A Day
I Leave The Bowl Out All Day
Food
Do you give your dog treats?
Yes
No
Type of Treats
Does your dog get "table scraps" or people food?
Yes
No
Untitled
Please describe a typical 24-hour period in your dog's life
Do you exercise your dog?
Yes
No
Exercise
Do you play with your dog?
Yes
No
Playtime
How is your dog on a leash?
We have great relaxing walks
My arm usually hurts when we're done
We avoid walks because it's a crapshoot
Does your dog get overly excited?
Yes
No
Excited
Where did you acquire your dog and how old was your dog when you got them?
Briefly describe your dog’s behavior at the veterinary hospital
Do you notice a difference in your dog out in public vs at home?
Yes
No
Home vs Public
Does your dog socialize with other animals?
Yes
No
Socialize
Do you have a fenced in yard?
Yes
No
Fenced Yard
Does your dog demand to be petted?
Yes
No
Does your dog ever seem irritated by or resent petting?
Yes
No
Does your dog bark excessively?
Yes
No
Barking
Does your dog cower or run away if people talk loudly or act boisterously?
Yes
No
Is your dog comfortable in crowds?
Yes
No
How does your dog act when strangers come to the house?
How does your dog act when he meets or passes strangers away from the house?
How does your dog act when he meets strange dogs?
When both are on the leash
Is your dog frightened excessively by any noise?
Yes
No
When both dogs are off leashes
When your dog is leashed and the other dog is free
Noise
Does your dog chase any of the following?
Please select all that apply
Children
Jogger
Bicyclist
Skateboarder
Cats
Small Dogs
Vehicles
Wildlife
Other
Other
Does your dog urinate/defecate in the house?
Yes
No
Has your dog had any professional training?
Yes
No
Who
Please list any known current obstacles you feel that you have had in training with your dog
What types of reward does your dog respond to?
Select all that apply
Verbal praise
Petting
Specific Toy
Treats
Other
Other praise
What type of equipment do you use with your dog?
Select all that apply
Martingale collar
Flat buckle collar
Hands-free leash
Slip lead
Electric collar
Prong collar
Harness
Other
Other equipment
Which of the following does your dog do willingly?
Select all that apply
Sit
Down
Stay
Drop It
Leave It
Place
Come
Watch Me
Heel
Fetch
Tricks
Are there situations where your dog is less likely to obey given commands
What days are you available?
Sunday
Monday
Tuesday
What times are you available on Sundays?
Morning (9:00 - 12:00)
Afternoon (12:00 - 5:00)
What times are you available on Mondays?
Morning (8:00 - 12:00)
Afternoon (12:00 - 4:00)
Evening (4:00 - 6:00)
What times are you available on Tuesdays?
Morning (9:00 - 12:00)
Afternoon (12:00 - 4:00)
Evening (4:00 - 6:00)
My "Best Owner Possible" Emails
Each month I send out an exclusive email with relevant things that I believe help you to be the best pet parent. It could include exclusive giveaways or chances to interact with me, books, toys, articles, health, videos, and random weird things I discovered to keep you updated on all things pets.
Sure, I'll check it out
Nope
Guidelines of Service
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I have read and understood the
Guidelines of Service
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