Thank you for contacting Family Paws.  Please take some time to fill out this questionnaire.  It is meant to provide me with helpful information regarding you and your pet.  There are no right or wrong responses to any of the questions.  It is important for me that you provide me with the most accurate information so that I can better help you and your canine family member.
Please indicate which type of consultation you are requesting.  
workshop    Private consult    Phone consult
Your contact information

Today's Date:

Last Name:
First Name:
Spouse:

If expecting, due date?
Obgyn Practice name:

Children?
Name & Age:
Name & Age:
Name & Age:

Address:
City:
State:
Zip:
Phone numbers:
Email address:
Preferred Method of Contact?
How did you hear of Family Paws?


Canine Information

Name:
Breed:
Age:
Sex (circle one):

Neutered Male
Male
Spayed Female
Female

Where did you get your dog?
What age was he/her?

Do you have any medical concerns?
If so, please explain.Your Veterinarian's Name:

Name of Animal Hospital or Clinic:
Street Address:
City:
State:
Zip:
Phone number:

Tell us about your dog
What training have you and your dog participated in?
What commands does your dog perform regularly?
Who has best control of your dog?

What do you enjoy most about your dog?
Least?

What is one behavior your dog has that you would like to change?

What methods of correction do you use with your dog?

What does your dog enjoy most?
Least?

What does your dog do when strangers approach him?
What does he do around other dogs?

Does your dog enjoy grooming (ex.  nail trimming, brushing)?
If no, how does your dog react?

What games does your dog enjoy?
What makes your dog uncomfortable?
How does your dog show stress?

Has your dog shown any form of aggression?
If yes, please describe the frequency and the behavior.

Equipment

What type of collar do you use with your dog?
What type of lead do you use?
Do you have any other type of equipment you use with your dog?


Diet

Type of food?
How often fed?
Are you using herbals, flower essence, vitamins or any other type of supplement?

Reason(s) for contacting Family Paws?

Other comments

Please tell me anything else that you feel will be helpful to me regarding your dog in particular.  You know your dog best and this helps me to get to know him/her as well.

Thank you again and I look forward to working with your family.  Family Paws will not share any of the above information without your permission.

--Jennifer Shryock

Dedicated to harmony and safety between kids and canines.


Jennifer Shryock
Canine Behavior Consultant and Teacher
Email: FamilyPaws@nc.rr.com
web: http://home.nc.rr.com/familypaws