Untitled Document

Questionnaire
CANINE COMMUNICATIONS DOG PSYCHOLOGY CENTER 2901 Exposition Blvd., Los Angeles, CA 90018 Phone (323) 731-0955 Fax (323) 731-0990 http://www.brandonfouche.com Brandon@brandonfouche.com Thank you for your interest in Canine Communications and Brandon Fouché This questionnaire is the first step in working with Canine Communications. Please explain issues as detailed as possible. If you have more than one dog, please include information and pictures for all of them. Once Brandon reads the form we will call you to ask additional questions. At that time we will let you know what Brandon recommends. If he feels that a consultation should be scheduled at a location appropriate to the issues, home, our facility or elsewhere. Often times a phone consultation is all that is required. All family members and anyone in contact with your dog should be there. Please allow at least a few hours. If he recommends his "boot camp", the dogs stay at our facility and work with Brandon for 14 days. We offer many services specific to each dog and their goals. Prices vary based on type of work required Once an appointment is scheduled, signed agreement, dog license, sterilization certificate and shot records (including current bordatella no later than 7 days prior to arrival). All dogs staying at our facility must provide their own food. All dogs coming from a shelter must first be quarantined for a minimum of 10 days. All payments are due at the time of service. Feel free to email or call if you have additional questions. Our office hours are 10 a.m. – 3 p.m., Monday through Friday
Date: Name: Referred by: Available days and times: Address: Home Phone: Cell Phone: Fax: Work Phone: Email: Veterinarian Phone & Address Emergency Contact Name & Phone: Age: Breed: Color: Weight: Scars: Fixed: Adopted from: What area did dog come from: How long with family: Family at home: Type of Home: House Condo Apartment Townhouse Medical Problems: Food brand and amount per day: Dog treats out of hand: Growls around food or bowl: Where does dog sleep: Crate trained: Dog allows you to groom: Plays with what kind of toy: Any training: Commands: Pulls on leash: Ever off leash: Any leash aggression: Aggression towards other dogs: Is dog hyper: Is dog a barker: Does the dog growl: Growling at everyone or only at certain times: How is dog around kids: Allow you to pick them up: Dog knows when you are upset with their behavior: Shows signs of submission: Start of issues: