Canine history form | Hopefordogs Canine Training

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Canine history form

Canine history form

This form will take you approximately 5-10mins to complete. It will help us have a better understanding of the dog and it's history before we commerce the training.
- Step 1 of 6
Name *
Furkid's name *
Breed *
Age *
Gender: *
Boy
Girl
Spayed/Neutered: *
Yes
No
If yes, at what age?
Date of last vaccination *//
Bring along proof of records or upload below
File Upload (max. 5MB)
Where did you obtain the furkid? *
How old was the furkid when he/she joined your household? *
Does the furkid has a previous guardian? *
Yes
Nope
Not sure
If yes, briefly state the reason for giving up:
Behavioural Issues
When did you first noticed the behaviour? *
Is it an aggression issue?
Yes
No
Not sure
Has the dog bitten anyone? *
Yes
No
What triggered the bite? *
What is the severity of the bite?(Based on Dr Ian Dunbar's bite scale) *
Level 1 - Obnoxious or aggressive behavior but no skin-contact by teeth.
Level 2 - Skin-contact by teeth but no skin-puncture. May be skin nicks and slight bleeding caused by forward or lateral movement of teeth against skin.
Level 3 - One to four punctures from a single bite with no puncture deeper than half the length of the dog’s canine teeth. Maybe lacerations in a single direction, caused by victim pulling hand away, owner pulling dog away, or gravity (little dog jumps, bites and drops to floor).
Level 4 - One to four punctures from a single bite with at least one puncture deeper than half the length of the dog’s canine teeth. May also have deep bruising around the wound (dog held on for N seconds) or lacerations in both directions (dog held on and shook its head from side to side).
Level 5 - Multiple-bite incident with at least two Level 4 bites or multiple-attack incident with at least one Level 4 bite in each.
Level 6 - Victim dead
Describe its behavioural issues: *
What was your immediate reaction(s)? *
What methods have you tried to resolve the behaviour (if any)? *
How effective are methods/training? *
Has the behaviour changed in severity?
Worsen
Remains the same
Getting better
Do you and your members in your household find the behaviour serious? (scale=1 - 5)
Scale: 0

What do you wish to achieve with the program? *
Depending on the behaviour issues and your objectives, we may require more than 2 sessions.
Household Information
Do you have other pets in the houshold?
Yes
Nope
If yes, please list them *
Who are the main caregivers of the furkid? *
What are the main purposes of getting a furkid? *
Why did you choose him/her? *
Breed
Gender
Temperament
Looks
Others
What other reasons?
Have you previously had other furkids?
Yes
No
Where does the dog hang out during the day? *
Where does the dog sleeps at night? *
Exercise Routine
How often do you walk the dog? *
How long are these walks? *
What type of collar/leash do you use? *
Harness
Flat collar/Leash
Head Halter
Martingale/Slip leash
Others
What other type of collars?
Any other activities with the dog?
Do you have any of the following (If none, leave blank):
Snuffle Mat
Lick Mat
If blank if none
Training History
Has the dog receive any training before? *
Yes
No
Not sure
If yes, what type of training? *
Puppy Training
Obedience Training
Behavioural Modification
What school/trainer? *
How long ago was the training? *
Rate the dog's performance during the training: *
Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5
Does the dog know any cues/commands? *
Yes
No
What cues does the dog knows? *
Sit
Down
Stay
Come
Diet
How many times a day do you feed the dog? *
What do you feed? *
How do you feed him/her? *
Food bowl
Throughout the day during training
Puzzle/Enrichment tools
Free feeding throughout the day
Others
Select all that applies.
If others, please describe:
What type of puzzle/enrichment tools?
What is the speed when eating? *
Gobbles the food (1-3mins)
Moderate (3-5mins)
Slow (>5mins)
How often does the furkid gets new long-duration chews (E.g. bully sticks/yak chews/meaty bones)? *
Does he/she loves treats? *
Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5
Any food allergy? *
Yes
No
Not sure
If yes, what is he allergic to?
Health Status
When was the dog's last health check if any?
Does the furkid has any existing medical condition(s)? *
Yes
No
If yes, briefly describe the condition(s): *
When did it started?
Is he/she on any medication? *
Yes
No
If yes, please describe the type of medication, dosage and frequency:
Any possible side effects of the medication on its behaviour? *
Yes
No
Not sure
If yes, please briefly describe:
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Quick Links

Menu

Home

About

All Programs

Kinder Puppy Program

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Shop

Dog Trainer Course

Get In Touch

Privacy Policy

Professional Certifications

Certified Canine Behaviour Practitioner
The International School for Canine Psychology & Behaviour Ltd

Aggression in Dogs Trainer
Master Course

Fear Free Certified Professional
Fear Free Animal Certification Program

Accredited Dog Trainer
International Association of Animal Behavior Consultants

Follow Us

Facebook Instagram Youtube

AVS Accredited Trainer

Make a Difference

Donate To SOSD

Jurong Island

With 200 dogs in our JI shelter, and another 150 strays that we feed, feeding the dogs on JI is quite a feat. Just for JI alone, SOSD needs to fork out an average of $5000 each month, even after huge discounts from suppliers.

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