Dog Trainer Report Form

Dog Training Company*

Dog Trainer Name*

First NameLast Name

E-mail

Phone Number*

Area CodePhone Number

Client Name*

First NameLast Name

Pet Name*

Client Phone Number*

Area CodePhone Number

Date of Session

Date

Next Scheduled Session with the pet

Date

Check off all the behaviors that you taught.

Please list any other behaviors taught, below.

Please list the reinforcers that you used and to which reinforcers the patient responded best.

Any new behaviors or concerns brought to your attention by the client or observed by you? Please give us as much information as possible.

Interactions with People

Interactions with Other Animals in the House

Aggression (e.g., lunging, baring teeth)

General Attitude

Ear Carriage

Body Position

Tail Position

Vocalizations (e.g, crying, whining, barking, growling)

Level 0-Low FAS Displays 1 or 2 mild signs of FAS, such as lip licking, avoiding eye contact, turning head away without moving away, lifting paw, partially dilated pupils, and/or panting but commissures of lips are relaxed, occurring fewer than 4 times a minute. Interested in reinforcers (treats, play, attention) and choose to interact.

Level 1-Low FAS-Displays 1 or 2 mild signs of FAS, such as lip licking, avoiding eye contact, turning head away without moving away, lifting paw, partially dilated pupils, and/or panting but commissures of lips are relaxed, occurring fewer than 4 times a minute. Interested in reinforcers (treats, play, attention) and choose to interact.

Level 2-Moderate FAS-Displays 1 or 2 moderate signs of FAS, such as ears slightly back or to the side, tail down, furrowed brow, moving slowly, overly attention seeking, and/or panting with a tighter mouth (dog), occurring 4 or fewer times a minute. Readily accepts reinforcement (treats, toys, attention). Still soliciting social interactions.

Level 3-Moderate FAS-Displays more than 2 moderate signs of FAS occurring more than 4 times in a minute. May refuse reinforcements for brief moments. May also be hesitant to interact but not actively avoiding.

Level 4-High FAS-Severe signs of FAS without aggression, such as immobility, fidgeting, escape behavior, dilated pupils, excessive panting (dog), increased respiratory rate, trembling, tense closed mouth, ears back, and/or tail tucked or thrashing (cat). May or may not be accepting any types of reinforcers. Not interested in interacting and may be showing active avoidance (moving away).

Level 5-High FAS-Severe signs of FAS with aggression, such as growling, lunging, barking, hissing, snarling, and/or snapping.

Fear, Anxiety, and Stress (FAS) of pet when you arrived for the session.

Fear, Anxiety, and Stress (FAS) of pet just before departing the session.

What recommendations were made and accepted by the Pet Parent?

What recommendations were declined by the Pet Parent?

Are there any challenges, questions or topics about which you would like the FVBS team to follow up?

Anything else that our team should know about the visit?

Have videos or pictures to upload?

Click here.

Dog Trainer Report Form

Client/Patient details

Behaviors Taught

Body Language

Rank the stress of the pet on a scale of 0-5 for when you arrived and just before departure. Use the scale below.