Consultation Form
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Date (today)
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Day
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Your Name
First Name
Last Name
Mobile Phone Number
Home Address including postcode
E-mail
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Dog's Name
Dog's Age
Breed
Gender
Male
Bitch
Vet Practice
Neutered or Spayed
Yes
No
Is your dog currently on any medication?
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No
If yes, which medication and why?
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How would you describe your dog's character?
How long has your dog lived with you?
Where did you get your dog?
Is this your first dog?
Yes
No
How many people live with you, ages of any children?
Who is the dog's primary trainer in the home?
Other dogs in the home?
Yes
No
Name, breed and age of other dogs
How often is your dog walked?
How long does each walk last?
How long is the dog left alone in the average day?
What brand of food do you provide for your dog?
Is it wet or dry food?
Wet
Dry
Mixed
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Describe any previous history...
Detailed description of problem/issue...
How long has your dog been doing this?
Do you think there was a situation that may have caused it? Please describe...
If a bite was involved, did it involve a trip to the vets/casualty?
Yes
No
N/A
If a bite was involved, did it penetrate the skin?
Yes
No
N/A
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Your favourite dog-related tv shows/books etc...
Have you attended any previous training clubs or had a 1-2-1 with a trainer/behaviourist
Yes
No
Name of trainer/training club...
Top three issues you would like Tc Dog Training to address...
Where did you hear of Tc Dog Training?
Please Select
Clarendon House Vets
Elm Road Vets
Chelmsford Radio
BBC Radio Essex
Tony's Your Dog Magazine Articles
Dog's Today Magazine
Pets at Home
Pets Corner
101 Doggy Dilemmas Book
Banner at Chelmer Park (Galleywood FC)
CJ Grooming/Furlongs Grooming
The Galleywood Grapevine
The Village Emporium
Yell.Com
Friend or fellow dog walker
Association of Pet Dog Trainers (APDT)
Institute of Modern Dog Trainers (IMDT)
Google/Web
None of the above
If someone recommended Tc Dog Training to you, please tell us who and thank them!
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