SMART Support Consultation:Dog & Baby Form Name * First Name Last Name Your dog's name Email * When's your due date? MM DD YYYY What are the names of the adults that live in the home? Are there any children in the home? Names and ages: What experience does your dog have with young children? How does your dog respond to these encounters? Do you have other pets in the home? If so, do they get along? If not, please describe: Briefly describe your home layout: Where does your dog sleep & where do they like to spend most of their time when you are home? What professional pet services do you have available to you? For example: dog walker, daycare, boarding facility, pet sitter Does your dog have any of the following behavioural issues? Check all that apply Separation Anxiety Reactivity towards adults Reactive towards children Reactive towards other dogs Bite history Resource guarding None of the above Have you noticed any of the following? Check all that apply Limping or joint pain Restless at night Reduction in vision Reduction in hearing Increased urination House soiling Noise sensitivity Increased anxiety Loss of appetite None of the above In your opinion is your dog: Very thin A little underweight Ideal weight A little overweight Very overweight Please list out your dogs daily exercise and enrichment activities. Is your dog comfortable with: Check all that apply Vet visits Nail trims Grooming Being in a crate Staying over night with a friend Traveling in the car Being around active children What is your biggest concern at the moment? Please give me any additional information that you think might be helpful. Thank you! I’ll send you a Zoom link the day before our consultation - please reach out if you have any questions.
