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On a scale of 1 to 5, 1 being very untrained and 5 being very trained, how trained is your dog?
 
1- Does not know any commands
 
2
 
3- Knows sit, lay down, stay
 
4
 
5- Knows above and beyond normal day to day common commands
 
 
 
Who trained your dog?
 
Myself
 
Dog Trainer
 
Friend (untrained)
 
Other
 
 
 
 
On a scale of 1 to 5, 1 being very difficult and 5 being very easy, please rate the ________ of your dog.
 
1- Dog not attentive, did not seem to grasp commands
 
2
 
3
 
4
 
5- Dog very attentive, picked up on commands after 3 or less attempts
 
 
 
Have you ever, or recently thought about, hired a behaviorist/trainer for an undesirable trait that your dog possessed?
 
Yes
 
No
 
 
 
If yes, what was that trait?
 
Anxiety/fear
 
Destructive behavior
 
Disobedient/doesn't listen
 
Jumping/nipping/barking
 
Does not get along with other animals
 
Other
 
 
 
 
On a scale of 1 to 5 how obedient is your dog?
1 being very disobedient (does not listen to commands such as sit, stay, lay down) and 5 being very obedient (always listens to owners commands)
 
1- Does not listen to commands (e.g. sit, stay)
 
2
 
3- Obeys half of the time to commands (e.g. sit, stay)
 
4
 
5- Always listens and obeys commands (e.g. sit, stay)
 
 
 
Generally, how many times does one need to repeat a command (e.g. sit, stay) before your dog obeys?
 
Generally, my dog does not need to be told more than once
 
1-3 times
 
3-5 times
 
More than 5 times
 
 
 
Generally speaking, when one states a command, does your dog follow it immediately?
 
Yes
 
No
 
Sometimes (s)he does, sometimes (s)he doesn't
 
 
 
When your dog is hungry do they tend to
 
Wait by their food bowl or area where food is stored
 
Solve the problem by their own means (e.g. try to break into area food is stored, steal food off the counter, etc)
 
Follow human around whining/begging
 
None of the above
 
Other
 
 
 
 
When your dog needs to go outside do they
 
Stare at you and wait for you to let them outside
 
Wait by the door and wait for you to let them outside
 
Whine or bark
 
Deal with it on their own (e.g. eliminate in house, try and escape house, etc)

 
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