Intake Questionnaire — Chilled & Fulfilled

About you

I’m getting in touch about * My puppy (aged up to 5 months) My dog (adolescent or mature, aged 6 months or older) I need help choosing the right breed, breeder/rescue and/or puppy

Email address *

Your name *

Phone number *

Country

Suburb / town

Australian clients — helps me plan logistics. Overseas clients can skip.

State

I’m open to / seeking * (select all that apply) In person Online Train my dog for me & teach me

I’m interested in * (select all that apply) In person Online Not sure yet

If you were referred, who can I thank?

If someone referred you, please let me know who so I can thank them.

Your dog

Your dog’s name *

Your dog’s breed/s *

Age *

Sex and reproductive status *

If you are planning to desex your dog in the near future, consider delaying this decision until after the assessment.

Male – Not desexed Male – Desexed Male – Vasectomy / chemical castration Female – Not desexed Female – Desexed Female – Ovary-sparing hysterectomy

If your dog is desexed: at what age was it done, and did you notice any behavioural changes afterwards?

e.g. reduced roaming or marking, or increased anxiety, fear or reactivity. If not desexed, skip this.

Current medical issues or medication — and do they affect your dog day to day? *

Include anything that might cause pain, lethargy, reduced mobility or a change in mood.

Did you rescue your dog? * Yes No

What brings you here

The issues — what triggers your dog’s problem behaviour? *

For each thing your dog does that concerns you, tell me three things: what sets it off, where and when it happens, and exactly what your dog does. This is the part I read most closely, so pour it all out — there’s no limit, and nothing is too small to mention.

Include things like: home vs out on walks, on lead vs off lead, with all/most dogs or only some, strangers vs people you know, indoors with visitors, etc.

Examples: “On lead she lunges at most dogs that pass — off lead at the park she’s fine.” “When a man she doesn’t know approaches, she backs away and growls.” “When I vacuum, he barks and tries to bite it.” “When visitors arrive he jumps, barks and can’t settle.”

Bite history. Has your dog EVER bitten another dog, person or animal, or had any close calls — even in self-defence? *

What do you think may have contributed to your dog’s issues?

Could be specific or general — a scare or attack, an accident, illness or pain, a big change like a house move, something from before you had them, or just how things unfolded. Not sure? That’s fine.

Is the issue currently getting better, worse, or staying the same? * Better Worse Same Not sure

Have you previously worked with another trainer on the issues you are seeking help with? * Yes No

Home & household

Are there children living in, or regularly visiting, your home? If so, what ages?

Who else lives with you — any other adults, and any other pets? *

Has your dog shown any tension, warning signs or aggression toward anyone in the home, human or animal?

Warning signs can be subtle — stiffening, growling, guarding, or avoiding someone.

Is anyone in your household pregnant, or planning a pregnancy, in the next two years?

Optional and confidential. The more notice I have, the better I can prepare your dog for a baby’s arrival — so it can also affect how soon I’m able to fit you in.

Yes — currently pregnant Yes — planning within the next ~2 years No Prefer not to say

Daily life & management

Food type for daily meals (not counting occasional treats) (select all that apply) Kibble Air-dried Cooked roll (like Prime100) Home-cooked Raw Other

How does your dog feel about their food? * Loves food, gobbles it up Finishes the meal but in no rush Eats but doesn’t finish the meal Sometimes my dog doesn’t eat when I put the bowl down

Inside the home, my dog is motivated by *

If your dog had to choose just one of these inside the home, what would they choose?

Food / treats Play with me (ball / tug / frisbee etc.) Physical affection from me Verbal praise from me Something else

Outside the home, my dog is motivated by *

If your dog had to choose just one of these outside the home, what would they choose?

Food / treats Play with me Physical affection from me Verbal praise from me Other dogs Other people Chasing wildlife Something else

On a normal walk, my dog (select all that apply)

This is about walking mechanics — reactivity and big feelings belong up in the issues question.

Walks calmly on a loose leash Pulls a little Pulls a lot Stops and sniffs constantly, resists, hard to move on We don’t often walk — we do other things I avoid walks Other

Describe your dog’s weekly exercise / fulfilment routine. Include activity type and duration, and whether it’s affected by wet weather. *

e.g. “Work days: a 30-min morning walk plus backyard play. Weekends: a long beach run or bushwalk. On wet days we skip the walk and do indoor games.”

Is your dog crate trained? *

Defined as: capable of being in a closed crate without issue, and settles and relaxes fairly easily.

Yes No In progress Used to be, but not anymore

Impact & commitment

On a scale of 1–10, how much is this currently affecting your life? *

On a scale of 1–10, how much is this currently affecting your dog’s life? *

On a scale of 1–10, how committed are you to resolving it right now? *

How urgent does getting help feel right now? * Not urgent — I want to do this properly, in my own time Priority — I’d like to make progress soon Urgent — it’s significantly affecting us, and/or getting worse Critical — there’s real risk (a serious bite, a hard deadline such as a baby, a move or a complaint, or I’m considering rehoming the dog)

Realistically, how much time each day can you commit to developing your skills and your dog’s behaviour between sessions over the next 3–6 months? * Under 10 min 10–20 min 20–40 min 40+ min

Finishing up

Things my dog does really well — tell me about the situations where your dog is fantastic.

Anything else you’d like to share, or any questions for me?

Your puppy

Where are you at with your puppy? * I already have my puppy at home Coming home soon — I’ve chosen a specific puppy Still choosing my puppy (from a breeder / litter)

Your puppy’s name *

Exact breed/s *

e.g. “Border Collie x Kelpie” — or, if unknown, your best guess.

If not home yet, when do you expect your puppy to arrive?

Age — current age, or age at homecoming *

Please include the word “weeks” or “months”.

Sex * Male Female Not sure yet

Desexing plans * Not planning to desex Plan to desex around the standard age (6+ months) Will be / was desexed early (before 6 months) My breeder requires desexing by a certain age Undecided — I’d like your advice

At what age was / will your puppy be separated from their litter? * Under 6 weeks 6–7 weeks 8 weeks 9–10 weeks 11+ weeks Not sure / still finding out

Current or known medical issues, or any medication *

Where is your puppy from? *

Name the breeder, pound or rescue organisation — or mention Gumtree, a neighbour, a friend, etc.

If you rescued or rehomed your puppy, please include any known history.

Life with your puppy so far

Food type for daily meals (not counting occasional treats) (select all that apply) Kibble Air-dried Cooked roll (like Prime100) Home-cooked Raw Other

Is your puppy crate trained? *

Defined as: settles and relaxes in a closed crate without distress.

Yes In progress Planning to Not planning to Seeking guidance on this

Anything already worrying you, or any behaviours emerging so far? (e.g. nipping, toileting, fearfulness, settling)

Home & household

Who lives in your home? Please include any children and their ages. *

Do you have any other pets? If so, what are they? (And if your puppy’s already home, how are they getting along so far?)

Is anyone in your household pregnant, or planning a pregnancy, in the next two years?

Optional and confidential. The more notice I have, the better I can prepare your dog for a baby’s arrival.

Yes — currently pregnant Yes — planning within the next ~2 years No Prefer not to say

Experience & background

Have you personally raised a puppy or owned dogs before — and been the person responsible for their care and development? * Yes — I’ve been the primary person responsible I’ve had dogs in the household, but wasn’t the main carer No — this is my first time

Your vision & goals

Why did you get a dog — and why this puppy in particular? *

Of everything you ticked, which 3 matter most to you right now?

Just list your top three.

Do you intend for your dog to be involved in any of the following? (select all that apply) Therapy dog Assistance dog Working dog Protection Competitive sports / obedience trials Companion / family pet Not sure yet Other

How pressing does this feel right now? * Just planning ahead — no rush Keen to start early and get ahead of any problems We’re finding it hard and would like help soon We’re in crisis — exhausted and overwhelmed, and it’s taking a toll on the household

Realistic time per day to invest into your puppy’s development * Under 10 min 10–20 min 20–40 min 40+ min

On a scale of 1–10, how ready and committed do you feel to putting the early work in? *

Anything else

Anything else you’d like to share, or any questions for me?

What you’re after

What can I help you with? * (select all that apply) Working out whether now’s the right time to get a dog Choosing the right breed or type for us Choosing the right puppy from a litter Vetting a breeder / checking one out Finding a reputable breeder or source Something else

A bit of context

Where are you up to? *

e.g. just starting to think about it · decided on a breed but need help finding one · found a breeder and want a second opinion · choosing between puppies in a litter.

Tell me a bit about your household and lifestyle *

Who’s at home, how active you are, and what you picture a dog fitting into.

Is there a timeframe you’re working toward?

A litter due, a date in mind, or no rush.

Finishing up

Anything else, or specific questions for the consult?

One last thing

How would you like to do your assessment? * In person — Meet & Greet (Bruns) Phone call

About you

Your dog

What brings you here

Home & household

Daily life & management

Impact & commitment

Finishing up

Your puppy

Life with your puppy so far

Home & household

Experience & background

Your vision & goals

Anything else

What you’re after

A bit of context

Finishing up

One last thing

Thank you 🐾

Thank you 🐾

Thank you 🐾