Client Evaluation - Indianapolis Dog Wizard

Human Client Info

First Name*

Last Name*

Address*

Address 2

City*

State*

Zip Code*

Mobile Phone*

Work Phone

Email*

Preferred contact method*

Mobile Phone
Work Phone
Email

How did you find us?

Please tell us who (so we can thank them)

Your living situation:

House with yard and fence
House with yard, no fence
Apartment

Please list all the humans that live in the same house with your dog, including any children and their ages:

How Many Dogs Need Training?*

1 Dog
2 Dogs
3 Dogs

Dog Info

Dog Name*

Dog Age*

Dog Weight*

Breed/Mix and Color*

Dog Gender*

Male
Female

Spayed or Neutered?*

Yes
No

Where did you get your dog?*

Rescue Group
Breeder
Shelter
Other

What age were they when you got them?*

Dog #2 Info

Dog Name*

Dog Age*

Dog Weight*

Breed/Mix and Color*

Dog Gender*

Male
Female

Spayed or Neutered?*

Yes
No

Where did you get your dog?*

Rescue Group
Breeder
Shelter
Other

What age were they when you got them?*

Dog #3 Info

Dog Name*

Dog Age*

Dog Weight*

Breed/Mix and Color*

Dog Gender*

Male
Female

Spayed or Neutered?*

Yes
No

Where did you get your dog?*

Rescue Group
Breeder
Shelter
Other

What age were they when you got them?*

Medical Information

Health Concerns/Pre-existing conditions - Please list

What Vet Clinic do you use?

Do you vaccinate for all the regular recommended vaccinations?

Yes
No

Please specify which dog(s)

Do you vaccinate for bordatella?

Yes
No

Please specify which dog(s)

What is your feeding schedule at home?*

Feed twice a day
Feed three times a day
Feed Once a day
Leave food out all the time

Please specify which dog(s)

Does your dog usually eat his food right up?

Always
Most of the time
Picks at it leisurely

Please specify which dog(s)

What type of food do you feed your dog(s)?

Does your dog have any food allergies?

Yes
No

Please specify which dog(s)

If yes, please list:

Allergic to	Response if eaten

Does your dog have any housebreaking issues?

Yes
No

Please specify which dog(s)

Do you currently use a crate with your dog(s)?

Yes
No

Crate Information

Is your dog comfortable in a crate?

Yes
No
Never tried it

Please specify which dog(s)

What type of crate do you use?

Metal Wire
Plastic
Cloth

Please specify which dog(s)

Has your dog ever escaped the crate?

Yes
No

Please specify which dog(s)

When is your dog in the crate?

When we are not at home
Both when we are home and not
Only when he is in trouble

Please specify which dog(s)

Does your dog cry or bark in the crate?

Yes
No

Please specify which dog(s)

Does your dog use the bathroom in the crate?

Yes
No

Please specify which dog(s)

Does your dog eat in the crate?

Yes
No

Please specify which dog(s)

Going for a Walk

How many walks do you go on with your dog?

Several a day
Once a day
A couple times per week
Hardly ever because they play in back yard
Hardly ever because they are too hard to walk

Please specify which dog(s)

Does your dog seem to enjoy going for walks?

Yes
No

Please specify which dog(s)

Does your dog get nervous of people, dogs, or objects on walks? (Check all that apply)

Please specify which dog(s)

Does your dog pull on the leash?

Yes
No

Please specify which dog(s)

When do they pull on the leash?

All the time
Most of the time
Only if they see another dog
Only if they see a person

Does your dog do any of the following growl/bark/lunge on walks:

Bark/growl/lunge at other dogs
Bark/growl/lunge at people
Lunge and pull towards cats/birds/squirrels on walks
React to joggers/bikes/skateboards

Please specify which dog(s)

Socialization with People

Does your dog enjoy meeting new people?

Yes
No

Please specify which dog(s)

Does your dog jump on new people in an excited way?

Yes
No

Please specify which dog(s)

How does your dog react to meeting strangers?

Growls/Barks
Hides

Do they seem to do better with certain people?

Men
Women
Neither

Does he seem to react more to any of the following?

Hats
Glasses
Certain People

Once they make a friend, are they always good with them?

Yes
No

Please specify which dog(s)

How is your dog with kids?

Great
Ok
Not good at all
Never around them

Please specify which dog(s)

Have they ever bitten or attempted to bite anyone?

Yes
No

Did the bite break the skin?

Yes
No

Did the bite result in an emergency room visit or quarantine by animal control

Emergency Room
Quarantine
No

Describe details of any and all incident(s) where your dog(s) attempted or were successful in making contact to bite a person:

Have they ever growled, lunged, bitten you or others over food, toys, objects?

Yes
No

Please describe the incident and what it was over

Socialization with Dogs

Does your dog currently (or in the past) go to daycare?

Yes
No

Has your dog ever been kicked out of daycare?

Yes
No

If your dog has ever been kicked out of daycare, please describe why:

Is your dog good with small dogs?

Yes
No
Never around them
Select dogs

Please specify which dog(s)

Is your dog good with big dogs?

Yes
No
Never around them
Select dogs

Please specify which dog(s)

Has your dog ever growled, lunged, bitten other dogs or cats over food, toys, objects?

Yes
No

Please specify which dog(s)

Does your dog enjoy playing with other dogs?

Yes
No

Please specify which dog(s)

Does your dog have any dogs they are comfortable with?

Yes
No

Please specify which dog(s)

Has your dog ever been in a fight with another dog?

Yes
No
Multiple Fights

Did the incident/s draw blood?

Yes
No

Did the incident/s require stitches?

Yes
No

Describe the worst incident:

Does your dog have trouble being left alone?

Yes
No

Please specify which dog(s)

When you leave the house, does your dog?

Cry/bark/howl
Drool
Destroy things

For how long?

Less than an hour
2 - 4 hours
4 - 8 hours (or more)

Does your dog pee/poop when you are gone?

Yes
No

Please specify which dog(s)

What length of time are you typically gone for?

1 - 5 hours
5 - 8 hours
8 - 12 hours

Please check all other behaviors that apply to your dog:

Please specify which dog(s)

Additional Questions

Has your dog ever been on an invisible fence?

Yes
No

Please specify which dog(s)

Has your dog ever run through the invisible fence?

Yes
No

Has your dog ever worn a bark collar?

Yes
No

Please specify which dog(s)

Has your dog ever jumped a fence? If so, how tall was it?

Yes
No

If yes, how tall was the fence?

Please specify which dog(s)

Does your dog get on your furniture?

Yes
No

Please specify which dog(s)

Are they allowed on the furniture?

Yes
No

Where are they allowed? (Check all that apply)

Sofa
Chairs
Your Bed

Where does your dog sleep at night?*

What motivates your dog?

Please specify which dog(s)

Please tell us your top three training goals*

Have you ever tried any dog training with the dog(s) you are inquiring about?

Yes
No

Please explain the training techniques you have tried

What other training company have you worked with?

Please explain why you feel the results were not met and are seeking other training

Have you ever used an e-collar during training

Yes
No

Is there anything else you feel we should know about your dog(s)?

CAPTCHA

Human Client Info

Dog Info

Dog #2 Info

Dog #3 Info

Medical Information

Crate Information

Going for a Walk

Socialization with People

Socialization with Dogs

Additional Questions

Why Dog Wizard

Success Stories

Meet the Team