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About
- Brigette Mayer, Owner & Head Trainer
- Testimonials
Puppy Training
- Puppy Start Right Preschool
- Puppy Jumpstart
Dog Training
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Contact Us

Home
About
- Brigette Mayer, Owner & Head Trainer
- Testimonials
Puppy Training
- Puppy Start Right Preschool
- Puppy Jumpstart
Dog Training
Resources
Contact Us

Home
About
- Brigette Mayer, Owner & Head Trainer
- Testimonials
Puppy Training
- Puppy Start Right Preschool
- Puppy Jumpstart
Dog Training
Resources
Contact Us

Behaviour Modification Form

First Name

Last Name

Address

City

Postal Code

Province

Phone

Your Dog's Name

Breed or Mix

Coat or Colour(s)

Gender

Age

Weight

Sterilization

How did you hear about Harmony Animal Training & Behavior?

We value referrals! If you were referred to us, please let us know so that we can thank them!

Who is your dog's veterinarian?

When was your dog's last physical examination at the veterinarian?

Does your dog have any known medical issues?

Yes No

If YES, what are your dog's known medical issues?

Please list all medications and dosages that your dog is currently on (or input n/a).

Vaccination Status

My dog is up to date on all core vaccines. My dog has a positive titre test not older than one year. My dog is up to date on the rabies vaccine.

Where did you obtain your dog? Please include the name of the rescue, shelter, or breeder, if applicable.

Why did you obtain your dog (companionship, guard dog, sport competition, playmate for current dog, etc.)?

When did you obtain your dog?

If you obtained your dog as a puppy, how old was s/he when you brought her/him home?

Has your dog had any prior training?

Yes, group puppy class Yes, group adult class Yes, private lessons Yes, board & train Informal training at home No, but we're ready to learn

Who was the trainer?

Is your dog crate trained? (select one)

What training tools do you currently use with your dog? Check all that apply.

Flat collar Martingale collar Choke chain Prong collar Electric collar (shock / stim / vibration) Head halter (Gentle Leader / Halti) Body harness (Easy Walk / Freedom / Balance) Other - Please list below

Other training tool - please list.

Do you walk your dog using a Flexi or retractable leash?

Yes Sometimes No

Does your dog receive daily walks of at least 45 minutes per day?

Yes No

If your dog has food allergies, please list them here (or input n/a).

What brand(s) of food do you feed your dog?

Feeding schedule?

Free fed (food always available) Scheduled mealtimes (eats everything) Scheduled mealtimes (grazes)

Food Drive

High Medium Low Depends Not sure No interest in food/treats

Toy Drive (e.g.: playing fetch or tug with people)?

High Medium Low Depends Not sure No interest in toys

What behaviours are you looking for help with?

Barking Chewing Digging Fear & phobias Reactivity & aggression - with dogs Reactivity & aggression - with people Remedial socialization for adult dogs Resource guarding - with dogs Resource guarding - with people Separation anxiety

If your dog's behaviour is not listed above, please describe it here in detail.

How long have you been dealing with the issue(s)?

What behaviour modification have you done to date, if any?

Is your dog friendly with unfamiliar people?

Seems to love just about everyone Good with unfamiliar women Good with unfamiliar men Good with unfamiliar children Selective with all people Tolerant (okay in their presence, but doesn't like to be touched by strangers) Scared, avoids strangers Aggressive (growls, barks, lunges, etc.) Not sure

Is your dog friendly with unfamiliar dogs?

Seems to love just about every dog Good with big dogs Good with small dogs Good when off-leash only Selective with all dogs Tolerant (okay in their presence, but doesn't like to be sniffed or interact) Scared, avoids other dogs Aggressive (growls, barks, lunges, etc.) Not sure

Has your dog ever bitten a person (not including puppy nipping or play mouthing)?

No Not to my knowledge I'm not sure if it was play or aggressive My dog has growled but never bitten Yes, but the bite left no mark Yes, the bite bruised the skin Yes, the bite left a shallow puncture Yes, the bite left a deep puncture Yes, the bite tore the skin Yes, the bite left multiple punctures Yes, my dog has bitten multiple times

If YES, please describe the injuries inflicted in detail and explain the circumstances of the bite(s).

Is there anything else you would like us to know?

What days / time frames would work best for you to schedule a behaviour modification initial consult?

Professional dog training services in Langley, Aldergrove, Maple Ridge, Pitt Meadows, and Surrey in the province of British Columbia.

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Contact Info

Email Us
604-522-1002

Opening Hours

Monday to Thursday – 10am to 8pm

Friday – Closed

Saturday & Sunday – 10am to 6pm

We do our best to answer emails within 36 hours and return phone calls within 72 hours. Email is usually the fastest way to reach us.

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First Name

Last Name