Name *
Email *
Phone *
Pet's Name *
Breed *
Age *
Gender * --- Select Choice --- Male Female
Altered * --- Select Choice --- Yes No
HAS YOUR DOG PREVIOUSLY RECEIVED COLLAR TRAINING USING STIM OR VIBRATE? * --- Select Choice --- Yes No
DOES YOUR DOG CHASE OTHER ANIMALS SUCH AS CATS, SQUIRRELS, DEER, LIZARDS, OR SNAKES? * --- Select Choice --- Yes No
IS YOUR DOG FOOD MOTIVATED? * --- Select Choice --- Yes No
HAS YOUR DOG EVER BEEN BITTEN BY A SNAKE? * --- Select Choice --- Yes No
DOES YOUR DOG COMPLETED BASIC OBEDIENCE INCLUDING SIT, DOWN, LEAVE IT, AND RECALL? * --- Select Choice --- Yes No
IS YOUR DOG BRACHYCEPHALIC (SHORT-NOSED BREED SUCH AS BULLDOG, PUG, FRENCHIE, BOXER, ETC.)? * --- Select Choice --- Yes No
DO YOU REGULARLY WALK YOUR DOG ON TRAILS, NEAR RIVERS, OR IN WILDLIFE AREAS? * --- Select Choice --- Yes No
DO YOU EVER WALK YOUR DOG OFF LEASH IN OUTDOOR ENVIRONMENTS? * --- Select Choice --- Yes No
IS YOUR DOG CURRENT ON DISTEPMBER, PARVO, AND RABIES VACCINATION? * --- Select Choice --- Yes No
IS YOUR DOG ABLE TO SAFELY PARTICIPATE IN A GROUP CLASS AROUND OTHER DOGS AND PEOPLE? * --- Select Choice --- Yes No
ULTRASOUND-THIS IS USUALLY IN THE FORM OF A REMOTE THAT CREATES A SOUND THAT IS GENERALLY UNDESIRABLE FOR SOME BUT NOT ALL DOGS * --- Select Choice --- Yes No
AIR-COMPRESSED AIR MAY BE USED AS AN ADDITIONAL FORM OF COMMUNICATION IF A DOG IS STRUGGLING IN A SPECIFIC AREA OF SNAKE AVOIDANCE TRAINING * --- Select Choice --- Yes No
WATER-WATER IS NEVER USED ON THE FACE AS PUNISHMENT. IF USED IT WOULD ONLY BE LIGHTLY APPLIED TO AREAS SUCH AS THE BACK LEGS AS A BRIEF FOCUS INTERRUPTION TO HELP REDIRECT THE DOG TOWARD THE DESIRED BEHAVIOR. * --- Select Choice --- Yes No
VERBAL CUES/NEGATIVE MARKERS-VERBAL CUES SUCH AS “NO” OR “EH-EH” ARE EXAMPLES OF NEGATIVE MARKERS USED TO INTERRUPT BEHAVIOR AND REDIRECT THE DOG TOWARD THE DESIRED RESPONSE. * --- Select Choice --- Yes No
VIBRATE-IN THE FORM OF A COLLAR AND MAY POTENTIALLY BE USED FOR DOGS WITH STRONGER PREY DRIVE TO HELP INTERRUPT FIXATION AND REDIRECT THE DOG TOWARD THE DESIRED BEHAVIOR. * --- Select Choice --- Yes No
CITRONELLA-IN THE FORM OF A COLLAR AND MAY BE AN EFFECTIVE TOOL FOR STRONGER PREY DRIVE. * --- Select Choice --- Yes No