Dog Venture Form2

Client Information

Your employment is :
You are away from home on average per day for:
Which of the following activities do you do with your dog on a daily basis:
Activity time in minutes per day on average:
How many hours does your family sleep for each night:
Realistically how much time can you commit each day to improving your dog’s physical and mental well-being through a Canine Enrichment Program:
Realistically how much time can you commit each week to improving your dog’s physical and mental well-being through a Canine Enrichment Program:
List any constraints or other factors for us to consider regarding your individual time constraints:
What is your main goal, what do you want to achieve through the development of a Canine Enrichment Program for your pet?

Home Environment

You currently live in:	Condo/Apartment Townhouse Single Family Home Multi Family Home Mobile Farm
How large is your home?
Is your home?
Do you have a yard/garden?
What size is your yard/garden?
Is the yard/garden secure for pets to enjoy off leash
Do you have a swimming pool
Is your pet allowed to use the pool?
Who lives in the home with you and the pet?	Adults Children less than 8 years of age Retirees Teenagers
Do you have other pets in your home?	Dogs Cats Equine Pocket Pets Birds Other Other:

Dog's Information

Your Dog’s Name:
Date of birth:
Breed:
Sex:
Neutered/spayed?
Has this dog had other owners?
How long have you had this dog?
What is your dog’s relationship to the other people and animals in the household (friendly, hostile, fearful)?
When did your dog last have an annual wellness check with your veterinarian?
Is your dog current on the following vaccinations?	Rabies DHPP
When did your dog last have a fecal test?
Does your dog have any medical conditions?
If yes, please note details of any medication:
Where does your dog sleep at night?	Other:
How many hours a night does your dog sleep?
Is the dog’s sleep uninterrupted?
How is your dog contained when you are out of the home?
How well does your dog relax in your home when there is no activity?
When your pet is left “Home Alone” do you?
Did your dog attend a puppy socialization class?
Have you ever attended pet dog manners (obedience) training classes with your dog?
Does your dog reliably do the following when asked?	Sit Down Stay Come Fetch Wait Name recognition
Has your dog ever participated in any of these activities?	Agility Disc dog Flyball Scent Training Fun Scent Games Competition Obedience Dock Diving
Has your dog ever participated in any of these activities?	Collars Harness 6-foot leash Long line Other:
How do you exercise your dog each day?	Leash Walks Back Yard Games Training Games Swimming Run with my Dog Bike with my Dog Other:
On average per day how long do you exercise your dog ?
What do you feed your dog?	Kibble Home cooked Raw Other
How do you feed your dog?	Bowl Interactive food toy Hand feeding
What treats does your dog enjoy?	Dry cookies Real food treats Soft moist treats Bones
What toys does your dog enjoy?	Balls Squeaky Kongs Discs Tug Chase
What does your dog do when you have guests?
How does your dog behave around other dogs?
Please indicate if your dog gets stiff, growls or shows teeth when:	Reaching for collar Reaching for feet Hugging Handling of mouth Near other dogs At the vet Near Strangers Have not seen
How is your dog when left alone?
How is your dog during thunderstorms/fireworks?
Does your dog guard resources?

Young Woman Walking With Beagle Dog In The Summer Park. Obedient

My promise to you

As a DogSmith professional, I pledge to use my knowledge and skills for the benefit of pet owners and their pets.

I will practice my profession conscientiously with dignity, and in keeping with the principles of The DogSmith ethics, mission, vision and values.

I accept as a lifelong obligation, the continual improvement of my professional knowledge and competence.

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