Assessment Form

Fill out this assessment form in order to schedule a consultation. Expect an email response within 48 hours of submission. If you do not receive an email within this time you can email me at alyssa@legendsdogtraining.com Thanks in advance for taking the time to fill this out.

Name *

First

Last

Phone Number

Email *

Do you live in San Diego?

• Yes
• No

If yes, what neighborhood?

If no, what city, state (or city, country for international clients)

What type of home do you live in?

• Apartment
• Complex
• House (with Yard)
• House (with No Yard)
• Other

What application do you prefer to do the online video consultation? *

• Zoom
• Skype
• FaceTime

What service are you interested in? *

• Consultation (stand alone service)
• Consultation + Online Classes
• Not sure, would like a recommendation

Dog's Name *

Dog's Age *

Dog's Breed (approx weight for mixed breeds) *

Best guess for mixed breed dogs, along with approximate weight.

Gender *MaleFemale

Spayed or Neutered *YesNoSoon

Where was the dog acquired? *BreederRescueShelterFriend, family or acquaintanceOther

How long have you had the dog? *

Health Concerns

Do you have more than one dog that needs training? *YesNoGood question, maybe

Names of people that have regular contact with dog, provide age and relation if under 18. *

Provide age and relation if under 18

Do you have other pets?

Provide names, ages and specify type (cat, dog, hamster).

Where does dog stay when home alone? *

• Free Range (Inside)
• Limited access to house
• Crate
• Outside
• He is never home alone

Where does dog stay during day? *

• Free Range (Inside)
• Limited access to house
• Tethered to me (to assist in potty training)
• Outside

Where does dog stay at night? *

• Free Range (Inside)
• Limited access to house
• On human bed, mostly
• On dog bed, mostly
• Crate
• Outside

Is your dog crate trained? *

• Yes, loves the crate
• Tolerates the crate
• Attempted crate training
• No longer uses crate
• No, prefer not to use crate
• Would like to crate train, not sure how to get started

Any previous training? *

• Yes, group class
• Yes, private lessons (basics)
• Yes, private lessons (advanced)
• Informal training at home
• Nope, but s/he's ready to learn!

Does your dog go on daily walks?

On walks do you use a collar or harness?

• Front clip harness (clips on dog's chest)
• Regular harness (clips on dog's back)
• Head Halter (fits on dog's head)
• Regular collar
• Martingale collar
• Slip or choke collar
• Pinch or prong collar
• Other

Allowed on Furniture? *

• Couches
• Beds
• Only with Invitation
• Not allowed on furniture

What type of food does your dog eat?

Does your dog have food allergies?

Feeding Schedule? *

• Free Fed
• Schedule (eats everything)
• Schedule (grazes)

Is your dog social with unfamiliar people? *

• Seems to love just about every person!
• Good with unfamiliar women
• Good with unfamiliar kids
• Good with unfamiliar men
• Selective
• Tolerant (okay in their presence, just doesn't like to be pet by strangers)
• Exhibits fearful, reactive or aggressive with unfamiliar people
• Not sure

Has your dog ever bitten a person? (not including play mouthing/biting) *

• No
• Not to my knowledge
• My dog has growled, but never bitten
• Yes, but it left no mark
• Yes, the bite bruised the skin
• Yes, the bite left a shallow puncture
• Yes, the bite left a deep puncture
• Yes, the bite tore the skin
• Yes, the bite left multiple puncture wounds
• Yes, my dog has bitten multiple times

When guests enter my home, my dog: *

• walks up to greet guests
• ignores guests
• jumps
• barks a few times
• barks but settles quickly
• barks non stop
• whines
• wiggles
• hides
• pees involuntarily
• charges guests
• growls
• threatens to bite
• has bitten
• is in a crate
• is behind a gate, or in an exercise pen
• is in another room
• is outside
• I'm not sure, don't have many guests

Is your dog social with unfamiliar dogs? *

• Seems to love just about every dog!
• Good with big dogs
• Good with small dogs
• Good when off-leash only
• Selective
• Tolerant (okay in their presence, just doesn't want to be sniffed)
• Exhibits fearful, reactive or aggressive behavior with unfamiliar dogs
• Not sure

Has your dog ever bitten another dog? (not including play mouthing/biting) *

• No
• Not to my knowledge
• I'm not sure if it was play or aggression
• My dog has growled, but never bitten
• Yes, but it left no mark
• Yes, the bite bruised the skin
• Yes, the bite left a shallow puncture
• Yes, the bite left a deep puncture
• Yes, the bite tore the skin
• Yes, the bite left multiple puncture wounds
• Yes, my dog has bitten multiple times

Food Drive *

• High
• Medium
• Low
• Depends
• Not sure

Toy Drive (retrieving, or playing tug with people)

• High
• Medium
• Low
• Depends
• My dog only plays with other dogs
• Not sure

High Drive: loves chasing, retrieving or playing tug, all day, every day. Medium Drive: loves to play, but only at home, and only for short periods of time. Low Drive: Not all that interested in toys. Choose all that apply.

Check issues that you would like to discuss with Trainer. *

• House training
• Destructive tendencies
• Jumping on people
• Behavior with guests
• Excessive Energy
• Excessive Barking
• Fearful Behavior
• Anxious Behavior
• Separation Anxiety
• Aggressive behavior with dogs
• Aggressive behavior with people
• Resource guarding (food, toys, people, space) with dogs
• Resource guarding (food, toys, people, space) with people
• Runs away
• Stealing food
• Demands attention
• Submissive/excitement urination
• Pulling on leash
• Barks on leash at dogs
• Barks on leash at people
• Barks on leash at moving objects (bicycles, skateboards)
• Barks on leash at wildlife
• Other

Specify "Other"

How do you reinforce desirable behavior? *

• Praise
• Food rewards
• Toy rewards
• Life rewards (walks, sniffing, playtime)

How do you address undesirable behavior? (ie. jumping, barking) *

• Interrupt
• Redirect
• Verbal reprimand
• Physical reprimand
• Correction with training collar
• Other

Referred by .. *

• Humane Society (Preferred Partner)
• Youtube
• Council for Certified Professional Dog Trainers
• Association of Pet Dog Trainers Website
• San Diego Dog Training Directory Website
• Referred by family or friends
• Referred by vet
• It's the Pits (Pit Bull Rescue)
• Second Chance Dog Rescue
• Google Search
• Other

It's ideal to begin training shortly after consultation, meeting once each week. If you plan to move forward with training, are you able to start within 1-2 weeks of consult? *

• Yes
• No, I have travel plans or other commitments
• I plan to do consult as stand alone service

Anything else you would like us to know?

Explain your primary goals in training: ie. relationship building, strengthening communication, minimizing stress/fear/anxiety, improving social behavior with people or dogs..

Phone

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