Background Form for Behavior Consultations

All Fur Paws, LLC

Thank you for contacting me. Having problems with your dog makes life challenging and stressful. Please know I do not judge. I am looking to gather information so I can provide the best help and guidance. WHen answer the questions below, provide as much information as possible. No detail is too small.

Behavior consultations are in in-depth process where we work together to develop a Behavior Improvement Plan for your dog. Consulatations are done in person or virtually via Zoom or Microsoft Teams. I use positive reinforcement and scientifically proven methods and techniques to modify behavior.

**I respond to form submissions within 48 hours. If you do not hear from me within that time or if the situation is urgent, email me at kwaugus@yahoo.com or call me at (920) 210-0764. I will respond as quickly as I can.

Owner Information

Owner's first name

Owner's last name

Street Address

City / State / Zip

Email . Verify accuracy! Main means of communication

Phone

Do you have children under 12 in the home or who frequent your home?

Yes

No

Other

Is your household busy or quiet?

Busy (lots of activity, people in/out)

Quiet (not many visitors)

Other

How many hours are you gone a day? How many hours is your dog home alone?

Who is the primary caretaker of your dog/pets?

Information About Your Dog

What is your dog's Name? Age? Breed?

Is this your first dog?

Yes

No

How long have you had this dog? Ar what age did you get him/her?

Where did you get your dog from?

Are there other pets in your home?

Yes, I have other dogs

Yes, other pets

No other pets

Other

What BRAND of food does your dog eat?

What prompted you to contact All Fur Paws? Was there is a specific incident? Incidents over time?

Training and Cues

Have you taken your dog to training classes or work with a trainer privalte?

Yes

No

Other

If Yes, provide business name or name of trainer(s) and location.

When did these issues first appear?

Health Information

Name of veterinarian/location/phone

Date of last vet exam

Does your dog have any medical concerns? Allergies?

No

Yes, Please list.

Is your dog on any medications or supplements?

No

Yes, Please list.

Is your dog up to date on rabies, bordatella, and distemper vaccitinations? (attach proof below)

Yes

No

No - state reason

Is your dog on heartworm medication?

Yes

No

Do not do heartworm testing

Please read and check each box.

As the owner above the said said dog, I agree the information provodied is true and accurate to the best of my knowledge.

I understand the fee for the Behavior Consultation is $275.00 and there might be a $100.00 scheduling fee.

I understand that the role I and all the caretakers of my dog plays an integral role in achieveing changes to my dog's behavior(s).

I understand there is no guaranty my dog will achieve the desired level of training or change in my dog's behavior, despite the best efforts of AFP.

I understand that changing unwanted or undesired behaviors takes time, patience, and training. There are no quick fixes.

By entering your name below, you acknowledge you have read and understand all the above statesments.

Proof of Vaccinations

Proof of vaccinations/other attachments

Proof of vaccinations/other attachements