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Is your dog:
Neutered
Spayed
Is your dog:
Male
Female
Are you the dog’s original owner?
Yes
No
Is your dog micro-chipped?
Yes
No
Does he/she chew furniture or other household objects?
Yes
No
Is your dog completely housebroken?
Yes
No
If no, check one of the following:
Has occasional accidents]
Sometimes, if left alone too long
Always kept outside
Other
Can he/she be left alone inside (without incident)?
Yes
No
Is the dog ever kept outside?
Yes
No
How was the dog confined outside?
Chain
Fence
Other
Is he/she crate trained?
Yes
No
Does he/she jump fences?
Yes
No
Being brushed/groomed?
Yes
No
Does the dog like baths?
Yes
No
Does he/she get into garbage:
No
Inside
Outside
Both
Does he/she enjoy riding in the car?
Yes
No
I don't know
Is your dog afraid of noises/people (i.e. thunder, fireworks, men, animals, etc.)?
Yes
No
Which of the following best describes this animal’s attitude toward other dogs?
Aggressive
Tolerant, but not playful
Reserved/cautious
Happy/Playful
Don’t know
Is he/she good with male dogs?
Yes
No
Is he/she good with female dogs?
Yes
No
Do you have any other dogs?
Yes
No
Do you have any cats?
Yes
No
Which of the following best describes this animal’s attitude toward cats?
Aggressive
Tolerant, but not playful
Reserved/cautious
Happy/Playful
Don’t know
Is this animal good with horses/chickens/farm animals?
Yes
No
Don't Know
Which of the following best describes this animal’s attitude toward children?
Aggressive
Tolerant, but not playful
Reserved/cautious
Happy/Playful
Don’t know
Is he/she good with children?
Yes
No
Don't Know
Do you have children?
Yes
No
Has this dog ever growled at anyone
Yes
No
Has this dog ever snapped at anyone?
Yes
No
Has this dog ever bitten anyone?
Yes
No
Has he/she had any obedience training?
Yes
No
Does he/she walk well on a leash?
Yes
No
Good off leash?
Yes
No
He/she is walked with a
Nylon collar
Choke chain
Harness
Does he/she know any tricks?
Yes
No
When was the last time he/she was at a veterinarian?
Last 3 mos.
Last 6 mos.
Last Year
Last 2 yrs.
More than 2 yrs.
Never
Is he/she current on vaccinations?
Yes
No
How often does he/she eat?
Once/day
Twice/day
3X/day
Free fed
What does he/she eat?
Dry
Canned

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