First Name *

Last Name *

Phone *

Email *

Postal code *

Address *

State *

City *

Have You Ever Owned A Dog? *

Have you Ever Trained A Dog? *

How Many Children Do You Have? *

How did you hear about K9Mania?

Additional Owner's Full Name:

Relationship (Co-owner, Partner, Relative, or Friend)

Dog's Name *

Dog's Breed *

Dog's Age *

How Old Was The Dog When You Acquired It? *

Gender *

Male

Female

How Long Have You Owned The Dog?

Has Your Dog Been: *

Spayed

Neutered

None of the Above

Where Did You Acquire Your Dog? *

Where Does Your Dog Sleep At Night?

Is Your Dog House Trained?

Behavior Problems Of Parents Or Littermates, if Known?

Dog's Weight *

Veterinarian

Vet Clinic

Rabies *

DHLP *

Level Of Success? *

What Commands Currently Work Best? *

Which Member Of The Family Has The Best Control? *

Does Your Dog Know How To Walk On A Leash? *

Yes

No

Trimming Nails? *

Giving Pills? *

Cleaning Ears? *

Grooming? *

Bathing? *

Patting Head? *

Being Lifted? *

Rolling Over *

Time Out *

Leash Correction *

Verbal Scolding *

Noisemaker *

Water Spray *

Rollover *

During The Day

During The Evening:

What Is Your Dog's Reaction To Your Departure?

What Is Your Dog's Reaction To Your Homecoming?

Do You Use A Crate?

Yes

No

Does Your Dog Like The Crate?

Yes

No

Cowering *

Ears Back *

Tail Tucked *

Retreating *

Hiding *

Excessive Salivating *

When Approached While Eating: *

When Approached With Treat Or Toy: *

When Dog Is Scolded: *

When Dog Is Pushed Off Furniture Or Bed: *

When Dog Is Approached While Sleeping: *

To Strangers Outside Of The House: *

To People Entering House/Yard: *

To Children Or Infants: *

To Other Dogs In Your Home: *

While In Car To People Outside Of The Car:

To Other Dogs Outside Your Home: *

Ever Aggrieve To Family Members? *

Yes

No

Has Your Dog Ever Bitten A Person? *

Yes

No

Has Your Dog Ever Been Reported To Animal Control For Biting? *

Yes

No