Changing Attitudes Application

Please fill out and submit this application to enroll in Changing Attitudes. You will be notified and invited to enroll if accepted.

Handler’s Name

Handler’s Email

Dog’s Name

Breed

Age

Sex
malefemale

Is the dog spayed/neutered?
yesno
At what age?

Age of the dog when it was obtained:

From: (shelter, breeder, etc)

Does your dog have any medical conditions, allergies, or take any medications? Please Describe:

Has your dog ever bitten a human (drawn blood)?
yesno
Briefly describe:

Has your dog ever bitten a dog (drawn blood)?
yesno
Briefly describe:

Does your dog live with or ever play with or get along with any other dog?
yesno
Briefly describe:

Briefly describe the issue with which you think a behavior class might help your dog:

Would you describe your dog as "excitable" in general (typically very active, distractable, unfocused?
yesno
Is your dog reactive (barks/lunches at) only to specific triggers (dogs, bikes, skaters, cars, other?)
yesno
If yes, in what situations is s/he reactive? (on leash, inside car, behind fence, looking out windows?)

If yes, describe typical reactive episode including how your dog looks and acts:

Briefly describe how your dog reacts to unknown people: (excited and friendly, greets calmly, nervous and afraid, tries to get away, growls/barks, uncertain/ambivalent, ignores them, dog never meets unknown people, etc.)

Please describe any other behavior issues your dog has (guards things, fearful, very territorial, etc.):

What have you done to deal with your dog's problems in the past?

How much/what kind of exercise does your dog get?

What kind/brand of food does your dog eat?

What kind of training classes or training methods have you and your dog been through?

What kid of equipment have you used with your dog? (Types of collars, leashes, other special training aids)

Is there any other information you think might be important?