919-946-0666 and his email is ncmike27609@yahoo.com

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Teamworks Dog Training, llcVACCINATION RECORDYou must bring a record of your dog's vaccinations (DHPP & rabies) with you to your lesson.The form below is provided for your convenience, however, you may bring photocopies of yourcurrent records. Dogs will not be evaluated unless proof of vaccinations or titers are presented.Name of Dog: _________________________________________ M/F:_________________ Age: ___________________Breed: _______________________________________________Name of Owner: ______________________________________Address of Owner: _________________________________________________________________________________________________________________________________________________Veterinarian & Clinic:______________________________________________________________________________________Date of DHPP or titer: _________________________________ Date of RabiesVaccination: _______________________Veterinarian's Signature: _____________________________________ Date: _________-------------------------------------------------------------------------------------------------------------------- ------9/20/11
Teamworks Dog Training, llcBEHAVIOR PROFILE FORMPlease complete these questions and return the questionnaire and send a copy to the address listedabove a minimum of 2 days before the lesson date if possible. Please being a copy of the completedquestionnaire with you to your lesson. All of your answers are confidential. Please bring proof ofvaccinations along to your lesson appointment.Dog's Name: _____________Owner's Name:_______________________1. What are the behavior problems that you are having with this dog?(Check boxes that apply and please indicate by each checked item if this problem is “very serious”,“serious”, or “not serious” for you and your family and make comments to explain the circumstances ofwhere and when your dog does these behaviors)Housetraining issuesDestructive behaviorJumping up on peopleNipping at hands, feetGrowling at strangersBiting strangersGrowling at family membersBiting family membersAggression toward strange dogsAggression toward dogs in familyAggression toward other pets in familyHandling issues (touching paws, ears, grooming, grabbing collar)Guarding food or bonesGuarding toysGuarding peopleGuarding house / propertyLack of attachment to familyOver-attachment to familyOver-protective of familyThunderstorm / loud noiseChasing other animalsChasing cars or other objectsFlip-flop changes in temperamentBarks / Howls a lotRuns awayBreed-specific behaviorsOther behaviors2. What have you and your family tried to do to address these problems already?3. What has worked?4. What hasn’t worked?9/20/11
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919-946-0666 and his email is ncmike27609@yahoo.com

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