Bark N Lunge - Registration of Interest

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* 1. Your Contact Information

Name

City/Town

Email Address

Phone Number

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* 2. Dog's Details:

Name:

Age

Breed

Sex

Desexed?

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* 3. Please select any behaviours that your dog exhibits (Aggression and Fear related)

Reactive to Strangers

Aggression/intimidation of household members

Reactivity to other dogs when on lead

Reactivity to other dogs when off lead

Barking

Movement Sensitivity / Prey Drive

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* 4. If a bite to Dogs

No Bite History

Bared Teeth / Snarl / Growl / Bark / Lunge

Snap (1)

Contact - No Damage (2)

1-4 shallow punctures (3)

1-4 deep punctures, bruising (4)

Deep bi-directional tears (5)

Multiple level 4 and 5 (6)

Mutilation or fatality

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* 5. If a bite to Humans

No Bite History

Bared Teeth / Snarl / Growl / bark / lunge

Snap (1)

Contact - No Damage (2)

1-4 shallow punctures (3)

1-4 deep punctures, bruising (4)

Deep bi-directional tears (5)

Multiple level 4 and 5 (6)

Mutilation or fatality

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* 6. How are you feeling while handling your dog in these scenarios?

Confident, I just want to know what I should do

I get nervous and feel the dog feeds on my reactions

I can no longer be involved in activities with my dog

I'm ok, but need help to build my confidence further

Other (please specify)

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* 7. I understand that not all dogs will be suitable for these sessions. I have provided honest information and would be happy to discuss my dog further before commencing training if needed.

Yes

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* 8. I am willing to participate in a short online session to learn some skills required for the training sessions

Yes