BOOKING – Murph & Me

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Name:

Surname:

Email:

Cell phone number:

Work number/next of Kin:

Physical Address:

Occupation:

Tell me about your past experiences with dogs. (What training methods have you tried in the past and what were the outcomes? Have you worked with a trainer/behaviourist before?)

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Information about your dog:

Name:

Breed:

Date of Birth:

Age:

Sterilized? (At what age?)

Energy Level of your dog:

Sex

MaleFemale

Where does your dog sleep?

Where does your dog eat?

Do you have any other dogs?

Tell me about your dogs’ history before you got him/her in much detail as possible, all information is vital.

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What behaviour challenges/training would you need help with? Please provide a description

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Has your dog ever bitten a person or dog?

	Yes	No
Person?
Dog?

If so when and how?

Was there any damage that needed veterinary or medical care?

If so, what happened and what were the circumstances?

Who is usually around when the challenging above behaviours occur?

Describe your dog’s personality and general mood.

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What is your dog’s Daily routine?

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How often does your dog get exercise?

Does your dog receive mental stimulation?

Is your Dog scared of anything? If so, please provide details:

Who all does your Dog interact with? (Other residents in the home, visitors, children)

How often does your dog interact with other dogs?

What is your dog’s diet? Please include all snacks or secret snacks given and the time they are fed:

What do you hope to achieve for you and your dog moving forward with training and behaviour?

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Dogs Medical Information:

Are your dog’s vaccinations up to date?

YesNo

What was your Dog vaccinated for?

Does your dog have any allergies or food allergies?

Name brand of Tick/flea tablet & de-worming tablet and date of when last your dog had them

When last has your dog been for a vet check-up?

Vet, Dr Name & contact details:

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Mention any and all medical concerns/diagnosis your dog has, include medication subscribed or any past medication or conditions, injuries or ailments.

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Is your dog microchipped?

YesNo

Terms & Conditions

Please note that guardian’s information will remain confidential, and your information will not be shared with a third party.

I have read and agree to the Terms & Conditions

	Yes	No
You
Stranger
Another dog
Family member

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