Reactive Class Questionnaire - Aunt Penny's Professional Dog Training

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Name*
First Last
Email*
Please list the email address that you want class notes & cancellations sent
Phone*
Address*
Street Address City State ZIP Code
Dog Information
Dog's Name*
Dog's Breed*
Male or Female?*
Spayed or Neutered?*
Age
Where did you adopt or purchase your dog?*
How long have you had your dog?*
Are there others dogs in the household?*
- yes
- no

Please list below their breed, age, sex and spayed or neutered.

Breed	Age	Male/Female	Spay/Neuter

Behavior Information
When ON LEASH, what does your dog do when he/she sees another dog?
Check all that apply
- Barks
- Lunges
- Growls
- Snaps
- Ignores
- Wags tail/greets other dog
- Hides behind owner/retreat
- Other
At what distance does this behavior happen?
If other, please note the behavior.
When OFF LEASH, what does your dog do when he/she sees another dog?
Check all that apply
- Barks
- Lunges
- Growls
- Snaps
- Ignores
- Wags tail/greets other dog
- Hides behind owner/retreat
- Other
At what distance does this behavior happen?
If other, please note the behavior.

How many times a week does your dog play with other dogs?*

Times per week	Where	On or off-leash

Other comments about play time:
Has your dog ever been in a dog fight?*
- yes
- no
How many times?
Please describe the fight below.
What happened? Was either dog hurt? Were there injuries? If so, please describe. Did either dog go to the vet?
What does your dog do when it sees or meets a stranger?
Check all that apply
- Barks
- Lunges
- Growls
- Snaps
- Ignores
- Bites
- Wags tail/greets other dog
- Hides behind owner/retreat
- Other
Has your dog ever bitten a person?*
- yes
- no
Did it break the skin?
Please describe the incident below.
What happened? Did the person see a doctor as a result of the bite? Were they provoked?
Have you taken classes with your dog before, or are you working with a private trainer?*
- yes
- no
Please list the class(es) taken, where and when.
Please describe the behavior problem you are hoping to correct by attending the class:*
Is your dog up to date on his vaccines including rabies?*
- yes
- no
How did you hear about this class?

CPDT-KA Nationally Certified Professional Dog Trainer
Licensed Family Paws Educator 🐾 Certified Fear Free Professional 🐾 Media Consultant 🐾 Dog Bite Prevention Educator
Advanced Certified Pet Technician through ABKA.

© 2026 Aunt Penny's Professional Dog Training

HOME
DOG TRAINING
DOGS & BABY CLASSES
PRESENTATIONS
ABOUT ME
CONTACT US