10.07.2015 Views

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

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

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

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Teamworks Dog Training, llc10. Health H<strong>is</strong>tory:What food do you feed your dog?What type of treats do you give your dog?When was your dog last vaccinated?Is t<strong>h<strong>is</strong></strong> dog being treated for or have any type of medical condition?Please explain:Was your dog on medication recently when any behavior problem incidentsoccurred?11. Home Environment:L<strong>is</strong>t types, genders, <strong>and</strong> ages of other pets at home:L<strong>is</strong>t names, ages, <strong>and</strong> gender of adults <strong>and</strong> children that live in the same household ast<strong>h<strong>is</strong></strong> dog: Please check all that apply <strong>and</strong> mark a % of the time t<strong>h<strong>is</strong></strong> occurs. Is t<strong>h<strong>is</strong></strong> dog:___ Allowed to run the neighborhood freely, outdoors, unsuperv<strong>is</strong>ed___ Inv<strong>is</strong>ible fence in both front & back yard___Inv<strong>is</strong>ible fence in back yard only___ In / Out Doggie Door to unfenced yard___ In / Out Doggie Door to fenced yard___ In a fenced yard with a fence that allows v<strong>is</strong>ibility out (chain-linked, split rail)___ In a fenced yard with a privacy fence that does not allow v<strong>is</strong>ibility out___In a dog run or pen___ Tied outside___ In the house loose with free range of the house___ In the house loose with limited range of the house___ In the house crated___ Other _________________________________Where does your dog sleep?Where does your dog stay when people are not home?My dog <strong>is</strong> allowed in these areas of the house or yard:My dog <strong>is</strong> not allowed in these areas of the house or yard:What type of residence do you have?___ Apartment___Townhouse / condominium___ House w/ a yard that <strong>is</strong> under 1/2 acre___ House w/ a yard that <strong>is</strong> over 1/2 acre___ Farm___ Other_____________9/20/11

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