Tailspin Petworx New Client Form For Dogs over Six months old
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Client Name FIRST AND LAST (as well as partner/spouse if applicable) *
Name and Mobile number(s) If entering more than one please separate with several spaces *
Please enter ONE email address for main contact: *
Street Address *
Unit Number
City and Province *
Postal Code *
Buzzer Code?
Do you have parking available? *
Details on parking if condo/building:
Dog's Name *
Breed or Breed Mix *
Date of Birth and Age of your Dog *
How old was your Dog when you acquired it? *
Where did you acquire your dog? *
 Name of the Breeder/Rescue/Shelter *
Is this your first dog? *
Is your dog male or female? *
Is your dog Spayed or Neutered? *
At what age was your dog spayed or neutered? *
What were your dog's early socialization experiences? (socialization is exposure to the environment, people, dogs, noise, etc. and does not necessarily mean dog play) *
Required
Notes on Early experiences:
Who is your main Veterinary Clinic and Doctor? *
What is your Veterinary Clinic's phone number? *
What is your Veterinary Clinic's Email?
Health concerns or injury history *
Required
Notes or details on above: *
Current Health Issues:
Current or ongoing medications or supplements *
Notes and comments on medicines and supplements *
Does your dog have sensitivities to certain foods or treats? What Kind?
What do you feed your dog? *
Required
What brand of food do you feed? *
What is your feeding schedule? *
Required
How many others live in your home? What are their names and ages? *
Is there anyone in your home (human or animal) that has special needs? *
Are there people with food allergies in your home?  What are they? *
Are there other pets in your home? Please list below. *
Notes on home information:
Where does your dog stay when you are not at home? *
Required
How long is your dog alone or crated at a time on an average day? *
How much physical exercise does your dog get in an average day/week? What kind? *
How much mental stimulation/training/enrichment does your dog get on an average day? (this includes training sessions, food toys, playing with you, going to new places on walks etc) *
Will you or do you attend dog parks with your dog? *
Does your dog go with a dog walker or to a dog daycare? *
Required
Who is your dog walker/daycare provider?
Does your dog go to a groomer regularly?
Clear selection
Who is your groomer?
How would you describe your dog's personality? *
What are three things you love about your dog? *
What are three things your dog loves? *
What are three things you enjoy doing with your dog? *
What is your idea of a good dog? *
What training tools are you currently using with your dog? Check all that apply *
Required
Has your dog had any previous professional training? *
Required
What tools were used?
What company did you train with? Which trainers?
Were you happy with your training experiences?
Clear selection
Why or why not?
Are you doing sports or specialty training currently with your dog or do you plan to in the future? *
If yes, what sports are you interested in?
Is your dog a Therapy Dog? *
Is your dog a Service Dog?
Clear selection
Is your dog an Emotional Support Dog?
Clear selection
What are your goals with your dog?
How do you generally respond to misbehaviour? *
What challenges in your life may affect your ability to work with your dog's behaviour? *
Required
What behaviours are you concerned with? Select as many as may apply. *
Required
Notes or Details: *
Does your dog have a history of Biting or Snapping at people? *
If Yes, Who did your dog bite or snap at? Check all that apply.
What part of the body were the snap/bites aimed at?
Please add details of circumstances here:
How damaging were the bites to people? Choose all that apply if there are multiple incidents (adapted from Dr. Sophia Yin bite scale)
Please detail incidents as fully as possible:
Does your dog have a history of biting or snapping at dogs or other domestic animals? *
If your dog has BITTEN or snapped at another dog or domestic animal where was the bite targeted? In multiple events check all that apply.
If Yes, Please add the circumstances here:
How damaging were the bites to pets/animals? Choose all that apply if there are multiple incidents (adapted from Dr. Sophia Yin bite scale)
What sort of management have you put into place to prevent future incidents?
 What things do you want to focus on first? *
How did you hear about Tailspin Petworx? *
Please tell me who referred you so I can thank them!
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