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Canine Enrichment Program Assessment Questionnaire

Step 1 of 7

14%

  • Personal Information

  • Please provide cell # if available.

  • About Your Dog

  • Breeder, rescue, shelter, as a gift, etc.

  • Dog Behavior

  • Dog Behavior Details

  • Check all that apply. If different for each dog, select other and specify.
  • Check all that apply. If different for each dog, select other and specify
  • Check all that apply
  • Check all that apply
  • Check all that apply
  • Check all that apply
  • Check all that apply. If different for each dog, select other and specify
  • Check all that apply. If different for each dog, select other and specify
  • Check all that apply. If different for each dog, select other and specify
  • (Touch his feet, look in his ears, check his teeth, etc.)
  • (Clip his nails, brush him, etc.)
  • Check all that apply
  • E.g. a bone, a toy, a sock he found on the floor.
    Couch, chair, bed, etc.
  • e.g. group classes, private lessons, board-and-train
  • Check all that apply
  • Example Reasons: I had a bad experience, My dog had a bad experience, I heard it was a bad tool, I'm afraid I'll hurt my dog, It seems complicated
  • Check all that apply
  • Check all that apply
  • This field is for validation purposes and should be left unchanged.

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