Comments
Has your dog been successfully socialized with other dogs?	Yes  No  Unknown
Has your dog been successfully socialized with men?	Yes  No  Unknown
Has your dog been successfully socialized with women?	Yes  No  Unknown
Is your dog aggressive with strangers?	Yes  No  Unknown
Is your dog aggressive toward people during walks?	Yes  No  Unknown
Is your dog aggressive with other animals during walks?	Yes  No  Unknown
Has your dog ever bitten a human or other animal?	Yes  No  Unknown
Has your dog been in training classes and/or private lessons?	Yes  No  Unknown
Has your dog been in day care before?	Yes  No  Unknown
If yes, when, for how long, reason for leaving?
Please check the following behavior issues that apply:
Separation anxiety	Nips in play	Toy possessive
Food allergies	Barks excessively	People possesive
Picky eater	Jumps up	Runs away
Shy	House soils	Allergies
Stool eater	Doesn't like to be grabbed by collar
Is there anything else we need to know about your dog?
I affirm that I have answered all of the above questions to the best of my ability and knowledge. I affirm that to my knowledge my pet has never bitten a human or another animal, nor has he/she been responsible for the death of any animal. By checking the I Agree button below, you are attesting to the accuracy of all statements. I agree to the terms above