Quarterly Report

Date

YYYY

Report is:

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

This is a new address since my last quarterly report

For PTSD and Autism Clients only: Are you still attending therapy sessions? If so, how frequently do you attend?

Dog

Dog's Weight (please enter number)

Please list the places you have taken your dog. If applicable please indicate if a new place was visited.

Are you having issues with your dog?(eg. pulling, lunging, jumping,barking, whining))

Have there been any changes in your lifestyle? (eg. with children, school environment, routine, health)

Are you having trouble maintaining a proper meet and greet? If so, please explain.

Have you used classical conditioning. If yes, please describe.

If you have left your dog home alone, please explain how long, how often, and if (s)he had any issues.

What food is (s)he on and how much?

What treats are you using?

Is your dog on any supplements?

What monthly meds is your dog receiving?

Are you cutting his/her nails?

Any concerns with your dog's ears, teeth, skin, stools?

Has your dog had any health issues or visited the vet since your last report? If yes, please describe.

Please describe your dog's excercise routine including play dates, off leash excercise, walks.

What skills provide you the most benefit?

Have you taught any new skills to your dog?

Please share a recent experience where your dog was invaluable.

If new address:

If using new veterinary practice, please submit name, address, phone number, and email

If you have new emergency contacts for yourself and/or dog, please list below.