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HDT Reactivity Question Form
DATE
NAME/S & PRONOUNS
Address
tel
Email address
NAME of dog
date of birth
weight
Breed
vaccines
vet
Date of last vaccine
spayed/newtered?
DATE OF LAST BLOOD TEST
How Did You Acquire Your Dog? How Old Was Your Dog? How Long Have You Had Him/her?
Why Did You Choose This Dog?
TYPE OF FOOD AND FEEDING SCHEDULE :
ANY HEALTH PROBLEMS (including allergies & injuries)?
RESTING PLACE :
Where Does The Dog Stay When He/she Is Alone And For How Long?
Does Your Dog Use A Crate Or Another Containment Area?
People The Dog Lives With Or Sees Frequently (At Least Weekly) : Do You Have Other Animals At Home? If So, How Do They Get Along?
How Does Your Dog React To Other Dogs Outside Your Home? How Often Does He/she Have Contact With Other Dogs?
Describe Your Daily Routine With Respect To Your Dog, Including The Exercise Your Dog Gets :
Have There Been Any Recent Changes At Home?
Death of family member or another animal
Divorce or departure of one of the members of the family
Change of work schedule - Birth of a baby
Arrival of another animal at home
Other
Do You Have A Dog Walker? If So, What Methods Does The Walker Use?
What Kind Of Collar, Harness And Leash (Please Specify Length) Do You Use With Your Dog?
What Do You Like And Dislike About Your Dog?
How Much Time Can You Spend Exercising And Practicing With Your Dog Daily?
Has Your Dog Had Any Previous Training? If So, Please Respond To The Following :
How long ago did you finish the training?
What methodology did the trainer use?
What did your dog learn?
How involved were you in the training process?
Has Your Dog Had Any Previous Training? If So, Please Respond To The Following :
How Does Your Dog React To Strangers?
Does He/she Have Any Resource Guarding Issues (Food, Toys, Bed, People)?
Does Your Dog Have A Strong Prey Instinct (Chasing Cars, Bicycles, Other Animals, Toys…)?
Is Your Dog Housetrained? If Not, Please Explain.
Does Your Dog Have Any Fears Or Phobias? Please Explain.
How Do You Normally Correct Your Dog? Under What Circumstances? How Does He/she React?
What Would You Like To Achieve Through Training?
What Do You Want Your Life With Your Dog To Look Like?
Aggression - Reactivity :
1) Has your dog ever bitten a person or another dog? If so, please describe what happened in as much detail as possible for every incident.
Include approximate dates of each incident and answer the following questions :
a) What do you think triggered your dog?
b) Have you noticed any pattern in the circumstances that trigger your dog?
c) How serious was the bite/s?
c.1) Did it cause a bruise?
c.2) Did it break the skin?
c.3) Did the person or animal have to go to the hospital?
2) Have you observed any of the following in your dog? If so, please describe.
a) Nervousness
B) Fear
c) Stress
D) Anxiety/Over-excitement
E) Pain
3) How long ago did the problems for which you are seeking support begin?
4) Please estimate how many hours/day your dog sleeps or rests (including the night).
5) What differences do you observe in your dog’s behavior on leash and off leash?
6) Is there anything else you think we should know?
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Last name
Email
Phone number
Message
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Email Us
info@holisticdogtrainers.com
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(510) 374-2776
Service Areas
Berkeley, Oakland, Lafayette, San Rafael and surrounding areas.
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