Pre-class Questionnaire

K9 Nose Work®

Pre-class Questionnaire

Please take a moment to answer the following questions about you and your dog.

If you have more than one dog, please fill out a questionnaire for each dog, though you may skip the questions that have duplicate information about your background and interests.

Handler’s Name (required)

Your Cellphone (required)

Your Email (required)

Dog’s Name (required)

Dog’s Breed

Dog's Age

Gender

Is your dog a

Where did you get your dog:

What age were they at the time?

Date Submitted

Mailing Address

City, State

Zip Code

Person to Contact in Case of Emergency (required)

Email (required)

Cellphone (required)

Do you have any health consideration, issue and/or concerns for you or your dog?

 

Are your dog’s vaccines current?

Name of the Veterinarian:

The Facility:

The Phone:

The E-mail:

List in order of preference your dogs favorite items to play with (does not need to be dog specific item)
1.
2.
3.
4.
5.

List in order of preference your dogs favorite food/treats (either for training purposes or just to eat; [ be specific: chicken, hot dogs, sardine, sweet potato, wrapped fish]
1.
2.
3.
4.
5.

 

Have you ever competed with a dog?

This dog?

Describe your dog’s daily activity level:

Has your dog ever damaged another dog?

If yes, how seriously?

Has your dog ever bitten a human?

If yes, how seriously?


Please describe trigger for incident:

How well does your dog play with other people other than you?

What are your expectations of this class?

What attracted you to this class?

Which activities or sports you have done with your dogs:
 Agility Tracking Obedience Rally Other

Please check off any fears (or nervousness) and phobias your dog may have:
 Strangers Other dogs Environments Noise Class setting Other


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