Please print clearly.
Dog's Name _________________ Breed ________________ Age ______
Sex ______ Altered? Y/N
Has your dog ever bitten anyone ? Y/N If yes,
describe __________________
________________________________________________________________
Does he growl? Y/N If yes, when? ___________________________________
Is he happy with: Vet? Y/N; Groomer? Y/N; Boarding? Y/N;
Can YOU: Brush him? Y/N; Trim his nails? Y/N; Clean his ears?
Y/N;
Is he protective of: Food? Y/N; Property? Y/N; Toys? Y/N; You?
Y/N;
Is he friendly towards dogs he doesn't know? Y/N;
Is your dog currently being treated for health problems? Y/N
If yes, describe ___________________________________________________
Is your dog free of external and internal parasites? Y/N
Name of Veterinarian _________________ Animal Hospital _____________
Telephone Number ___/_____________
Is trainer able to restrain dog at this point? Y/N _________________________________
Is handler physically challenged in any way? Y/N _______________________________
Does handler have hearing difficulties? Y/N; Language problems?
Y/N;