Kansas City's Dog Behavior Specialists

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Behavior Information Form

Behavior Information

Name*
FirstLast
Address
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Phone
Email*
Dog's Name*
Behavior and Obedience
Behavior problems to be covered:
- Aggression
- Biting
- Chewing
- Counters
- Crate Soiling
- Digging
- Fearful
- Furniture
- Growling
- Housebreaking
- Jumping
- Playbiting
- Separation Anxiety
- Socialization
- Trash
- Other
Check all that apply.
Other behavior problems to be covered:
Obedience to be covered:
- Autosit
- Come
- Down
- Following
- Heel
- Leave It
- Place
- Sit
- Stay
- Wait
- Other
Other obedience to be covered:
Barking
Does your dog bark at people?*
- Yes
- No
At whom or when?
Chewing
Do you catch your dog in the act of inappropriate chewing?*
- Yes
- No
Chewing on what?
(Owner agrees to offer appropriate toys upon your dogs return)
How do you react to inappropriate chewing?
Housebreaking
Is your dog housebroken?*
- Yes
- No
How many accidents per day?
Do you prefer your dog to eliminate on grass or pads?
- Grass
- Pads
Do you catch your dog in the act of pottying in the house?
- Yes
- No
How do you react when catching your dog pottying in the house?
Crating
Do you crate your dog?*
- Yes
- No
Does your dog eliminate in the crate?
- Yes
- No
(If so, your dog may need to stay longer than 28 days)
How often does your dog eliminate in the crate, and when?
How many hours is your dog kept in the crate?
What type of crate?
(A plastic crate is needed when your dog returns home if he or she has a chewing or housebreaking problem)
Exercise
Do you exercise your dog?*
- Yes
- No
How do you exercise your dog?
Program Expectations
What are your expectations of the program?*
What are your main concerns or problems with your dog currently?*
Do you understand the requirements and maintenance needed in order for the program to be successful?*
- Yes
- No
Terms and Conditions
I agree to the terms of this contract and verify that all information provided above is true. I hereby acknowledge and agree that I have read this contract, understand its terms and agree to all provisions by submitting this form to Beyond the Dog LLC.
By checking the box below, I hereby understand and agree to the terms and conditions set forth above.*
- I agree to the terms and conditions
Upon submission of this document, I am ensuring that all of the information I have provided above is correct. I further understand and agree to all of the terms and conditions in this document.
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