Evaluation Assessment Form – A Dog's Life Training School

Primary Contact Name*

Prefix First Last

Are there other members in the household besides yourself?*

Names and ages of all members in your household:*

Home Address:*

Street Address Address Line 2 City State ZIP Code

Your Best Phone Number:*

Your Email:*

Does your dog pull on the leash?*

Is your dog reactive to other dogs while on leash?*

Is your dog reactive to people while on leash?*

Is your dog timid/shy?*

Under what circumstances does your dog behave timidly/shy?*

Has your dog spent time socializing with other dogs?*

Is your dog comfortable around children?*

Under what circumstances is your dog NOT comfortable around children?*

Does your dog jump on people?*

Does your dog steal food or other items in the home?*

Does your dog come when called under any/all conditions?*

Does your dog let you groom them and handle their feet?*

Has your dog ever been in a dog fight?*

Please describe the circumstances in which your dog was in a fight with another dog.*

Has your dog ever bitten a person?*

Please describe the circumstances in which your dog bit another person or yourself.*

What are your primary goals for training?*

Are you committed to attending a mandatory follow-up training session, intended for the entire family?*

How did your hear about our training program?*

You may take this opportunity to ask us any questions or include any comments:

Name

This field is for validation purposes and should be left unchanged.

Pre-Evaluation Assessment Form