LinkedInThis field is for validation purposes and should be left unchanged. Thank you for taking the time to complete this questionnaire. This is designed to get the most information possible to prepare for our consultation and your treatment plan. I recommend that it is completed by the person who spends most time with your dog, but please do involve the whole family and if there are any areas that other family members may answer differently please highlight these at the end of the questionnaire.About YouYour Name:(Required) First Last Your Address:(Required) Street Address Address Line 2 City Postcode Your Phone Number:(Required)Your Email Address:(Required) Enter Email Confirm Email About Your PetDog's Name:(Required)Their Sex:(Required) Male FemaleDog's Date of Birth:(Required) DD slash MM slash YYYY Breed or mix:(Required)Where did your dog come from (breeder, rescue, previous home) and what's known of their history?(Required)At what age?(Required)Please describe your pet’s personality:(Required)Typical day (feeding, walks, play, rest, time alone)(Required)Reaction to people(Required)Reaction to dogs(Required)Reaction to new situations(Required)Has your dog ever bitten a person or animal or shown aggression to a person or animal? If yes, please provide information below.(Required)What training has your dog had and what commands do they respond to reliably?(Required)Behaviour ConcernsPlease describe the behaviour problem(s) you would like help with in as much detail as possible.(Required)When did this problem start?(Required)Are there any known triggers to the behaviour? E.g. something that happens before it?(Required)How do you currently respond to the behaviour, and what have you tried so far?(Required)Any other behaviour problems?Optional. List any other issues, most important first.Your SituationWhat would a good outcome look like for you and your dog?(Required)Booking DetailsDate and location of 1-1 booked:For home visits: Is there parking available?(Required)What made you choose Dogmestix?(Required)Where did you hear about Dogmestix?(Required)Please selectGoogle searchMy vetSocial mediaRecommendation from a friendAI assistant (e.g. ChatGPT, Claude)OtherAdditional Notes SectionPlease add all additional notes from the relevant questions in here.Notes:Consent and TermsDo you give your consent for me to discuss your details with your vet?(Required) Yes NoTerms and Conditions(Required)Thank you for completing this form. By returning this form you are agreeing to our terms and conditions which can be viewed at: https://www.dogmestix.com/terms-and-conditions I agree to the terms and conditions.
