Information Form Your Name * First Name Last Name Email * Phone * (###) ### #### Meeting Address (home, park, etc.) * Name of Dog * Age of Dog * Weight * Medical Conditions * Medications * Dietary Restrictions/Allergies * Please list all adult humans who live in the home. * Please list all children who live in the home, or who visit frequently. Please include ages. * Please list any animals who live in the home. Please include ages. * What are some of your dog's favorite activities? * What does your dog's daily routine look like? * Please describe the behaviors you would like to address. When do these behaviors occur? What happens right before and after? What does the body language look like? * If you have tried to modify the behaviors of concern in the past, what methods did you use? * Has your dog ever bitten a person or animal? Please describe any incidents. * Anything else you'd like to tell me about your dog? * How did you hear about working with me? * Thank you!