PUP Parent
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First Name
Last Name
PUP Name
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PUP Age
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PUP Weight (best guess)
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Shot History
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Please include last round and date of each.
Is your PUP on Flea, Tick, and Heart Worm Prevention?
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All three
Just Flea and Tick Prevention
Just Heartworm Prevention
None of these
Other Medication(s)
Please list all medication your dog is currently taking.
List any medical problems or important vet/medical history.
Does your PUP have allergies?
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Yes
No
Previous training or trainers?
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Yes
No
What are your training goals now?
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Do you currently have other pets in the home?
Yes
No
Is your PUP crate trained?
Yes
No
In Progress
Do not use a crate
Is your PUP house trained?
Yes
No
In Progress
What obedience skills does your PUP do well?
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Check all that apply.
Sit
Down or Lie Down
Wait
Stay
Mat or Go to your Bed
Loose-leash Walking
Other Tricks
None, I need help!
What behavior issues have you observed?
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Please check all that apply.
Jumping
Chewing
Digging
Barking
Over excited greeting
Escaping
Running Away
Hiding
Mounting / "humping"
Food Aggression
Toy Aggression
Protective Behavior / Jealousy
Marking / Peeing
Leash Pulling
Leash Biting
Lack of Listening
None
Does your PUP have bite/aggression history?
Yes
No
Unknown
Does your PUP visit dog parks?
Often
Sometimes
Rarely
Never
Not Yet
No, due to issues at the park(s)
Dog Park Issues
Please explain any issues you have had a a dog park.
While walking, how does your dog react to humans?
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While walking, how does your PUP react to other animals?
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At home, is your PUP afraid of strangers?
Yes
No
When someone enters the home, which best describes your PUP?
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Check all that apply.
Stranger Danger - Reacts only when someone enters.
Stranger Danger - Continues a non-relaxed state while someone is in the home.
Tentative - Relaxes after a few minutes.
Making Friends - Seems to be better on the second or consequent visits.
Friendly - Acceptable level of friendliness
Too Friendly - Unacceptable level of friendliness
Anti-Social - Does not seem to care or notice.
Is your PUP afraid of strangers in public or on walks?
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Yes
No
Sometimes
Does your PUP have fear or anxiety?
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Yes
No
Unsure
When there is an issue how does your PUP react?
With fear, anxiety, food, toys, surprise, etc..
FIGHT (growls, barks, holds stance, hair raised, charging)
FLIGHT (runs away, tucks tale, rolls on back, ears back, hides)
What types of walking equipment do you currently use?
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Food Information
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What brand of food, amount and frequency?
Types of management or barriers currently used?
Baby gates, Xpen, outdoor only, no barriers
How did you hear about Better PUPS?
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Friend / Referral
Business / Veterenarian Referral
I saw the Better-Pups-Mobile!
Google
Facebook
Other
Does your pup have a primary Veterinarian
Yes
No