Congratulations on taking the first step towards training with us. Please fill out the following form as accurately as possible. I make an effort to respond to new submissions within 48 hours, but may occasionally be delayed in responding or overlook a form. If you do not hear from me within 48 hours, please call 773-430-7768 and we will go from there. Looking forward to working with you and your dog!
Ruth Crisler, CBCC-KA
Type of consultation you wish to schedule
20 minute (free at our facility and certain events)
1 hour ($75 at our facility)
In-home ($99 and up, depending on your location)
Dog's Age (date of birth if known)
Dog's age when adopted or purchased
Sex of Dog
Breed or Type
Name and location of breeder or rescue organization
Describe three things you like about your dog or enjoy doing with him/her
Are your dog's vaccinations current?
Veterinarian or Veterinary Hospital with your dog's records on file
Reason for Behavior Evaluation
What is the main problem or concern?
Please check off any additional issues
Urinates when excited or afraid
Overactive/doesn't settle easily
Nervous or easily stressed
Fearful or shy
Bolts through open doors
Pulls on leash
Doesn't come when called
Unresponsive to name or commands
Inattentive/short attention span
Steals food or objects
Guards food, toys or objects
Guards space or territory
Aggressive toward people
Aggressive toward dogs
Growls at family members
Has injured one more person
Has injured one or more dog
If guards, please explain.
If aggressive, please explain.
If has bitten or caused injury to a person, please explain.
If has bitten or caused injury to another dog, please explain.
If other, please explain.
Describe the most serious incident that has so far occurred (please note when this happened).
Describe the most recent incident.
How often is the main problem occurring?
Once a month or less
No more than once a week
Several times a week
Multiple times per day
This problem is increasing in
None of the above
What have you done to address or correct the above issues? Please indicate specific tools and methods if any.
Were these methods effective?
If you have worked previously with a trainer, behavior consultant, or veterinary behaviorist, please indicate when and what that work entailed.
What are your most urgent priorities?
What are your long-term goals for your dog?
Do you have a specific training program in mind?
How will you choose a trainer or training program?
How did you find See Spot Run?
How many adults reside in your household?
How many children?
What other pets do you own?
How many visitors come to the home on average each week?
Is this your first dog?
In what style of home do you live?
Do you have a yard?
Where does your dog sleep?
Do you crate your dog? If so, when and how does he tolerate it?
Do you ever confine your dog to a room or area of the house?
How much time does your dog spend loose in the home unattended?
How did you choose your current dog?
Do you know or were you given information regarding your dog's parents, littermates, or early history?
Is your dog social with new people?
Is your dog social with other dogs?
How much social interaction with other dogs has your dog had, either on-leash or off?
Do you visit dog parks or send your dog to daycare? If so, where and how often?
Has your dog ever boarded at a boarding facility? Did you get any feedback from the facility about your dog's stay?
Describe your dog's play style or manner of interaction with other dogs?
Check off any commands or skills you have taught.
If you have trained with a food marker (ex: a clicker, "yes!", or "good"), please indicate it here.
If you have trained with a release word (ex: "free," "okay," or "break"), please indicate it here.
What do you feed your dog, how often, and how much?
Is your dog under or overweight?
Does your dog suffer from allergies?
Please list any current or recent medications. If current, please give dosage and schedule.
Has your dog been diagnosed with, or do you suspect, any medical conditions?
Has your dog ever suffered any serious injuries?
If your dog has bitten, was it reported? Please give details.
Was skin broken or medical treatment required? Please give details.
When did you first notice signs of aggression?
Check any known or suspected aggression triggers.
Direct or heavy eye-contact
Approach or physical contact while eating
Approach or physical contact while resting
Approach or physical contact while having a toy
Other physical correction or punishment
Approach or presence of children or infants
Is there anything else in your dog's history that we should know?
Please confirm the following:
I verify all the above answers are accurate to the best of my knowledge.
Should be Empty: