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/Handlers Name/s*

    Your Cellphone*

    Your Email*

    Dog’s Name*

    Dog’s Breed

    Dog's Age

    Gender

    Is your dog a

    Where did you get your dog:

    What age were they at the time?

    Mailing Address

    City, State

    Zip Code

    Person to Contact in Case of Emergency*

    Email *

    Cellphone*

    Do you have any health concerns for you or your dog, any dog allergies?

    If yes, what is it?

     

    Are your dog’s vaccines current?

    Name of the Veterinarian:

    The Facility:

    Phone/Email:

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

    List in order of preference your dogs favorite food/treats
    1.
    2.
    3.

    Who referred you?

    Name of Friend or Veterinarian who referred you if applicable

    Are you a trainer?

    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:
    AgilityTrackingObedienceRallyOther

    Please check off any fears (or nervousness) and phobias your dog may have:
    StrangersOther dogsEnvironmentsNoiseClass settingOther


    captcha

     

    Please type the letters/numbers into the box above before you submit