Client Profile

About You

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25% of survey complete.

Please complete all questions to the best of your ability as it will help us provide the most appropriate service.

If you have any questions in regards to completing this survey, please email jacqui@thedogproject.com.au

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* 1. Your first name(s) & surname(s)

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* 2. Address

Street address

Suburb

State

Post Code

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* 3. Best contact number

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* 4. Email

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* 5. Have you attended formal dog training before?

Yes

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* 6. If "yes", how long ago?

Within the last 12 months

Less than 5 years ago

More than 5 years ago

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* 7. If "yes", with which dog?

This dog

Another dog

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* 8. If "yes", what type?

Correction (choker chain)

Positive reward based

Combination

Other (please specify)

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* 9. Do you have any medical conditions that may impact training (e.g. mobility, sight, or hearing conditions)?

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* 10. How many people live at your home?

	0	1	2	3	4	5	6	7
Children	Children 0	Children 1	Children 2	Children 3	Children 4	Children 5	Children 6	Children 7
Teenagers	Teenagers 0	Teenagers 1	Teenagers 2	Teenagers 3	Teenagers 4	Teenagers 5	Teenagers 6	Teenagers 7
Adults	Adults 0	Adults 1	Adults 2	Adults 3	Adults 4	Adults 5	Adults 6	Adults 7

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* 11. What age children do you have at home?

N/A

0 - 5

6 - 10

11 - 14

15 - 18

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* 12. Which of the following best describes the property you and our dog live on?

Flat/ unit

House and average yard

Acreage

Other (please specify)