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Top Dog Trainer in Oceanside, CA | Mary Kay Snyder | 760-518-5518|marykay@101dogtrainer.com

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Evaluation Questionnaire101DTAdmin2024-05-20T15:00:18-07:00

Evaluation Questionnaire

Please fill out this form to the best of your ability.

Date(Required)

Month

Day

Year

How did you find out about me?(Required)

Your Information

Owner's Name(Required)

First Last

Occupation/s(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Cell Phone (with area code)(Required)

Do you use your cell phone for texting?(Required)

Yes

No

Email(Required)

Home Phone (with area code)

Your Dog's Basic Information

Name(Required)

Sex(Required)

Breed(Required)

Age(Required)

Where did you get your dog?(Required)

Describe your dog in 3 words(Required)

Your Dog's Health

Veterinarian(Required)

Clinic(Required)

Health Issues:(Required)

Vaccinations:(Required)

Rabies Vaccination

Bordetella Vaccination (Kennel Cough within last 6 months)

DHLLP Vaccination - Distemper, Hepatitis, Parvovirus, Leptospirosis

Flea & Tick Preventative

Your Dog's Home Life

How many adults live in your dog's home?(Required)

How many kids live in your dog's home?(Required)

How many other pets live in your dog's home?(Required)

Please describe your lifestyle/your family's lifestyle on a daily/weekly basis.(Required)

Where does your dog sleep?(Required)

What is your dog's daily exercise routine?(Required)

What brand of food do you feed your dog?(Required)

What is your feeding schedule?(Required)

Once Per Day

Twice Per Day

Free-Fed

Other

Your Dog's Behavior & Training

Is anyone afraid of your dog? Who/why?(Required)

Does the dog growl at anyone or anything?(Required)

Has the dog ever bitten anyone for any reason? If so, please describe in detail below.(Required)

How does your dog behave at the veterinarian's office?(Required)

Has your dog been socialized with adults, children, and/or other dogs?(Required)

Does the dog have any training? Please describe the training type with as much detail as possible.(Required)

How much time do you have each day to train your dog?(Required)

If your dog does something wrong, how do you correct it?(Required)

Is your dog used to being in a crate?(Required)

Yes, during the day

Yes, during the night

Yes, during both the day and night

No

Other

What motivates your dog: Food, toys, or affection?(Required)

What types of collars have you used on your dog?(Required)

Flat collar

Harness

Martingale

Prong

Citronella spray

Bark

Shock/Electronic

Invisible fence

Other

What other collar type(s) have you used on your dog?

What does life look like with your dog over its lifetime?(Required)

Please describe the frustrating behaviors of your dog below.(Required)

Goals - What is success to you?(Required)

What happens if you don't resolve the issue/s?(Required)

Are you willing to make some changes to facilitate the issues you are having with your dog?(Required)

Yes

No

How committed are you to making the necessary changes on a scale of 1-10?(Required)

101 Dog Trainer - Certified Professional Dog Trainer in Oceanside, CA

Contact Mary Kay Snyder

Phone: 760-518-5518

Email: [email protected]

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