Section 1: General Information

Your Name

First Name

Last Name

Phone Number

(###)

###

####

Email Address

Address (if applicable)

Please provide your physical address if we are scheduling an "in-home behavior assessment" or "puppy proofing" consultation.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

How did you hear about us?

Choose all that apply

Friend/Family referral (please provide name)

Vet or Groomer referral (please provide name)

Internet Search (Google, Yahoo, Bing, Yelp, etc)

Facebook

Other Social Media (YouTube, Instagram, etc)

Expo/Event

Other

Please provide the name of your referral (if applicable)

Section 2: Household Information

Spouse or Significant Other (if applicable)

First Name

Last Name

Spouse's Phone Number (if applicable)

(###)

###

####

Spouse's Email (if applicable)

How many adults live in your home or frequently visit?

How many children live in the home or frequently visit and what are their ages?

Are all members of your household aware of and in agreement with bringing a new puppy into the home? And if not, what are their concerns or objections?

Do you or does anyone in your household smoke?

Due to severe smoke-related allergies, if you or anyone you live with smokes (including the use of e-cigarettes and cigars), we will need to meet outside or virtually via video calls. Thank you for understanding.

Yes

Have you been prescribed an Emotional Support Animal or Service Animal by a physician?

Is anyone in your home allergic to dogs?

Yes

Unknown

Allergies to other animals

Property Ownership

Own your home

Rent your home

Live with extended family

Other

Type of Residence

Single-family House

Condo/Townhouse

Apartment Complex

Mobile Home

RV/Camper

If you do not own your home, does your residence allow pets?

Please provide the landlord/property manager's contact information (name & phone number)

Does your residence have a yard or outdoor area for pottying and exercise?

Yes

Please describe the yard and if there is a boundary fence.

Do you plan on moving in the foreseeable future? If yes, what is you plan for your dog?

Section 3: Previous Experience & Current Dog's Information

Please share as much detail as possible regarding any dogs you've had in the past or currently own. Their behaviors and current relationship with you will have a massive impact on this new puppy and we want to ensure we set you all up for success. *If you have never had a dog before, you may skip this section.*

Briefly share any past experiences raising a puppy or dog.

If children live in your home or frequently visit, have they lived with or ever been around dogs in the past? (if applicable)

Please tell us your philosophy regarding children and dogs. Do you have any concerns about your children being around dogs? How would you deal with an issue between a new puppy and your child?

Do you currently have any other pets?

If any other dogs (or cats) live in the home and will interact with your new puppy, what is their species, breed, age, gender, weight?

Is your dog spayed/neutered?

We will not judge you one way or the other. In fact, you may be surprised by what we have to say about this topic.

Yes

Is your dog up to date on vaccinations?

We will not judge you one way or the other. In fact, you may be surprised by what we have to say about this topic.

Yes

Are there any known behavior or medical issues with your dog we need to be aware of?

Include any recent injuries or surgeries (including spay/neuter), chronic illnesses, medications with dosage amounts (including antibiotics or probiotics), allergies (environmental or food related) and any special instructions.

Does your dog break out of his crate, rush out the door, jump over or dig under fences, or attempt other means of escape?

Is your dog comfortable with new people, new dogs, and new environments? If not, please explain.

Does your dog have any fears? Please list them.

Example: fireworks, thunder, motorcycles, loud noises, men with beards, etc.

Does your dog show any signs of stress or anxiety? If so, please explain.

Example: whining or barking non-stop, growling at strangers or strange animals, scared of sudden movement or new objects, destroys property or attacks out of fear

What is your dog's general attitude towards and around his food?

always starving, picky, protective or guarding it from other members of the household, couldn't care less, begging at the kitchen table?

Has your dog ever guarded, growled, barked, or lunged at other dogs or humans, especially children and puppies?

Please provide the context and be as detailed as possible. Examples: guards/growls when you or others approach his food, toys, bed, or crate. Or growls when you try to remove him from his bed or furniture. Or lunges/recoils from human touch or approaching dogs.

Has your dog ever bitten another dog or human regardless of severity or reason?

Please provide the context and be as detailed as possible

Has your dog ever bitten the groomer, the vet, or vet tech?

Please provide the context and be as detailed as possible

Please describe a typical vet or grooming visit.

i.e. stressful, relaxed, anxious, muzzle is required, he loves his vet/groomer

Has your dog ever been medicated for any behavioral issues? If so, why and which medication?

Section 4: New Puppy Information

Why are you wanting a new puppy?

I.E. companionship, adventure/running buddy, medical assistance like a service dog or ESA, fill the void of an older dog who passed away, etc

Who is this new puppy for? And who will be the primary caregiver?

I.E. yourself, one of the kids, adult parents, etc

How soon are you planning to purchase, adopt, or rescue a new puppy?

Describe your future puppy's ideal personality and temperament.

Where will your puppy spend the majority of the day?

I.E. inside, outside, equal amounts inside/outside with access to a doggie door, doggie daycare while at work

Where will your puppy spend the majority of the night?

I.E. inside, outside, equal amounts inside/outside with access to a doggie door

How many hours per day do you anticipate your puppy being left home alone?

I.E. work, school, errands, church, travel, etc

Where will your puppy be confined while you are away?

I.E. backyard, play pen, crate, laundry room, etc

Describe the type and level of exercise you would prefer for your dog

I.E. couch potato, run around the yard, enjoyable strolls around the block, vigorous hikes, morning runs, long-distance running or biking, dog sports (agility, frisbee, freestyle, obedience competitions, schutzhund, etc)

Section 5: Training Experience

Have you ever been through training with a previous or current dog?

What format (group classes, private lessons, board & train, other)? And what was your experience like?

How do you plan to train your new puppy?

I.E. DIY, YouTube videos, attend group classes, private lessons with a trainer, send my puppy to boarding school

What type and level of training are you prepared to handle with your new puppy?

I.E. potty training, house training, crate training, proper manners and behavior (no jumping, humping, barking, pulling on leash), obedience commands, simple tricks, separation anxiety, mild aggression, CGC certification, therapy dog qualifications, service dog qualifications

Section 6: Preferred Service(s)

We offer a variety of services besides just Pick of the Litter. If you are interested in any of our other services, please select below.

Desired Service(s)

Select all that apply

Pick of the Litter only

Private Training

Group Training

Dog Sitting

Help me choose (I'd like to talk first)

If you choose to do training with us, what do you expect to achieve once training is over?

What is your maximum training budget?

Examples: <$100, $500, $1500, $2500, whatever it takes

Is there anything else you'd like to share or feel we should know?

Desired date to begin service(s)

YYYY

Section 7: Consultation Guidelines

We require all adults in the home (i.e. spouses, partners, roommates, extended family that live in the home or visit regularly) to be present for the consultation (whether in-person, or over Zoom), if at all possible, as we want to ensure we address everyone's goals and concerns. Your willingness and ability to do the training together as a family are essential to achieving long-term success. You have hired us as professionals to help you find a new puppy/dog and start your new life together on the right food. Please be respectful of our time and expertise. Be ready at the designated time with all distractions turned off or put away and all participants seated.

Please type your name below, indicating you have read the above guidelines and will follow them during your consultation.

First Name

Last Name

Thank you for choosing Bakers Acres K9 Academy. We look forward to working with you and your dog!

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