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Dog Training
Pet Grooming
About Us
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Training Evaluation Questionnaire

Name:(Required)

First Name Last Name

Phone:(Required)

Email(Required)

Dog's Name:(Required)

Dog's Age(Required)

Breed:(Required)

Color:(Required)

Dog's Weight:(Required)

Dog's Overall Health:(Required)

Sex:(Required)

M

F

Spayed or Neutered:

Spayed

Neutered

N/A

Current Behavioral Issues & Goals

Does your dog pull on a leash?(Required)

Yes

No

If yes, how much of an issue is this for you? (10 being most concerning)(Required)

1	2	3	4	5	6	7	8	9	10

Is chewing an issue (shoes, furniture…)?(Required)

Yes

No

If yes, how much of an issue is this for you? (10 being most concerning)(Required)

1	2	3	4	5	6	7	8	9	10

Does your dog have accidents?(Required)

Yes

No

If yes, how much of an issue is this for you? (10 being most concerning)(Required)

1	2	3	4	5	6	7	8	9	10

Does your dog damage anything when you are away?(Required)

Yes

No

If yes, how much of an issue is this for you? (10 being most concerning)(Required)

1	2	3	4	5	6	7	8	9	10

Is your dog showing aggression towards other people or dogs?(Required)

Yes

No

If yes, how much of an issue is this for you? (10 being most concerning)(Required)

1	2	3	4	5	6	7	8	9	10

Is your dog reactive to other dogs while on a leash?(Required)

Yes

No

If yes, how much of an issue is this for you? (10 being most concerning)(Required)

1	2	3	4	5	6	7	8	9	10

Does your dog show fear?(Required)

Yes

No

If yes, how much of an issue is this for you? (10 being most concerning)(Required)

1	2	3	4	5	6	7	8	9	10

Does your dog beg for food at the table?(Required)

Yes

No

If yes, how much of an issue is this for you? (10 being most concerning)(Required)

1	2	3	4	5	6	7	8	9	10

Does your dog vocalize too much (bark, howls, whines etc)?(Required)

Yes

No

If yes, how much of an issue is this for you? (10 being most concerning)(Required)

1	2	3	4	5	6	7	8	9	10

Does your dog jump on house guests?(Required)

Yes

No

If yes, how much of an issue is this for you? (10 being most concerning)(Required)

1	2	3	4	5	6	7	8	9	10

Is your dog crate trained?(Required)

Yes

No

Is your dog socialized with other dogs?(Required)

Yes

No

Does your dog have any allergies?(Required)

Yes

No

Is your dog allowed on furniture?(Required)

Yes

No

Is your dog on any medications?(Required)

Yes

No

Special Instructions

Please list all training tools you have used with your dog?(Required)

Please list training words already being used?(Required)

Training Goals

Sit on verbal command(Required)

Yes

No

Improve social skills with other dogs(Required)

Yes

No

Improve socialization with people(Required)

Yes

No

Walk calmly on a leash(Required)

Yes

No

Walk by side OFF leash(Required)

Yes

No

Minimize/control jumping(Required)

Yes

No

Lay down on verbal command(Required)

Yes

No

Down & stay (short duration)(Required)

Yes

No

Down & stay (long duration)(Required)

Yes

No

Come on verbal command on leash(Required)

Yes

No

Come on verbal command OFF leash from distance(Required)

Yes

No

Minimize unwanted barking(Required)

Yes

No

Manage separation anxiety(Required)

Yes

No

Reduce play biting / nipping(Required)

Yes

No

Manage chasing of kids / people(Required)

Yes

No

Eliminate destructive behaviors(Required)

Yes

No

Anything else you think we should know about your pet:

Δ

Get Your Pets Looking Great and Smelling Sweet!

Enjoy a FREE Bandana and Fun Scent with all Grooming Services!

Call us now (215) 752-3661

Contact Us

Town and Country Pet Care Center
393 Langhorne Ave.
Langhorne, PA. 19053

Phone
(215) 752-3661

Fax
(215) 752-7109

Email
info@townandcountrypetcarecenter.com

*Lodging offer requires a 3-night minimum stay. Discounts subject to availability and blackout dates, and cannot be combined with other offers. Discounts apply to first-time customers only. Because safety is our number one priority, pet parents must schedule a daycare assessment for their dog prior to attending daycare. Upon successful completion of a daycare assessment, your dog's first day of play is free!

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