Client Registration Form – Behavior Consultation

This form is best completed on a computer, not a mobile device.  Please take your time and be as thorough and honest as possible.  The more information we know ahead of time, the better prepared and efficient we can be to help you.

Client Registration Form - Behavior Consultation

Client & Dog Information

First
Last
N/A if not applicable.
I'd love to see your favorite picture of your dog! Share it here.

Maximum file size: 52.43MB

Address
City
State/Province
Zip/Postal
Country

Health Information

Physical Symptoms

Does your dog have any sound sensitivity to the following noises?
Type "NA" if not applicable.
Type "NA" if not applicable.
Type "NA" if not applicable.
Does your dog have any hesitation doing the following?
Does your dog have any of the following?

Dog's Routine

Training History/Reinforcers

Client Goals

Fear or Aggression Toward Humans

Bite levels as defined by Dr. Ian Dunbar
Type "NA" if not applicable.
Type "NA" if not applicable.
Type "NA" if not applicable.
Type "NA" if not applicable.
Type "NA" if not applicable.

Fear or Aggression Toward Dogs

Type "NA" if not applicable.
Type "NA" if not applicable.

Separation Anxiety

Type "NA" if not applicable.
Type "NA" if not applicable.
Type "NA" if not applicable.
Type "NA" if not applicable.