Resource Guarding Questionnaire Step 1 of 2 50% Client InformationToday’s Date* MM slash DD slash YYYY Client's Name* First Last Home/Cell Phone*Email* Dog InformationDog's Name:* Date of Birth* MM slash DD slash YYYY Breed or Breed Mix* Weight* Sex:* Female Male Spay/Neuter* Yes No OverviewBefore you acquired your dog, did he/she have a history of resource guarding or any kind of aggressive tendencies? Age of your dog when behavior began: Why does this behavior concern you enough to contact a dog trainer?Has your dog ever attended any kind of dog day care? If so, which one? Has your dog ever seen another trainer for this behavior? If so, who? Are any members of your household concerned about this behavior? Are any members of your household expecting to bring home a new baby or new dog anytime in the next 12 months? Attempted SolutionsWhat have you tried to change your dog’s behavior?Behavior AssessmentCheck off which behaviors your dog has displayed while guarding food or an object from a person or another animal:Hold the shift key down to select multiple optionsStiffness throughout his body while hovering over the object in his possessionStillness while staring at you, your hand, or the object in his possessionTrying to gulp down the food or toy in his possessionLow rumbling growlMoving the object away from youExposing teeth and/or snarlingSnapping at you or another dogTouched your skin with his/her teethBite with light bruisingBite with tearing of the skinBite with punctureMultiple bitesHas your dog ever bitten another dog while resource guarding? Yes No Has your dog ever bitten a person while resource guarding? Yes No At what distance does your dog typically start guarding something? What actions typically worsen your dog’s guarding behavior?Type of Resource GuardingWhat kinds of food does your dog guard? What kinds of toys does your dog guard? What kinds of clothing does your dog guard? What kinds of places or furniture does your dog guard? Other situations or objects your dog guards: Thank you for taking the time to fill out our registration form. These details will help us better serve you and your dog. We look forward to working with you! Please verify the information was entered by you. Thank you.I understand and agree to the policies at the bottom of this page.* Yes No Signature* Reset signature Signature locked. Reset to sign again By indicating my consent, I am signing this agreement electronically. I agree my electronic signature is the legal equivalent of my manual signature on this Agreement. If I am signing on behalf of another individual, I attest that I have the authority to do so.To submit your information, please hit send. If you do not receive confirmation the form has been sent, scroll up to make sure all required fields have been entered. Policies Paid pre-registration is required to reserve a space in class. There will be no refunds after class begins. Please make sure your dog’s vaccinations are up-to-date. Only healthy dogs may come to in-person classes and training. Owners should keep their dogs at home or reschedule private training in cases of sneezing, coughing, diarrhea or other potentially contagious symptoms. Owners are expected to maintain and reinforce training outside of the class setting. Children 8 and over are welcome at in-person group classes as long as they remain with their parents throughout class, and follow trainers’ instructions. At their discretion, instructors associated with Joyful Dog LLC have a right to refuse admission to or expel a dog/handler from class. Waiver I understand that attendance at a dog training class is not without risk to myself, my dog, members of my family or guests who may attend. I agree to release and hold Joyful Dog LLC, its instructors and teaching assistants, the training facility, and their respective officers, directors and employees harmless of any liability arising from this training activity and/or information or consultation provided by Joyful Dog LLC. I expressly assume the risk of damage or injury therefrom.
