AHP – About You and Your Dog Form AHP - About You and Your Dog Step 1 of 8 12% Please start by telling us your basic information: Your Name(Required) First Last What is your approximate age group?e.g. 40sAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Home PhoneMobile(Required)Preferred Email(Required) Where did you hear about Canine Thinking? Other adults who live at home with your dog This section is for you tell us about ALL ADULTS who live in your house but also about any other friends or family who spend significant regular time with your dogPlease list all other adults who live at home with your dog here:handy hint.... click the + on the right hand side to add more rows!NameApproximate age groupRelationship to youHow do they get on with your dog? Add RemovePlease put any other relevant information about these people here: Children who live at home with you: How many CHILDREN UNDER 18 live at home with you?(Required)If none, please enter 0Please enter a number greater than or equal to 0.Please give details here:Handy hint.... click the + on the right hand side to add more rows!NameAgeRelationship to youHow do they get one with your dog? Add RemoveIf there is anything else that it would be helpful for us to know about children living at home, please pop this information here: Medical issues it would help us to be aware of It is really helpful for us to know if you, or anyone at home, has any medical conditions that may affect how you interact with your dog or how you may wish to work with us. We will make every effort to put adjustments in place wherever we can - our aim is for life with your dog to be as easy and enjoyable as possible and in particular, please let us know if there is anything we can do to make sessions more comfortable for you. Please tell us how you are affected and how we can best help (or put 'for info' if it is just so we are aware)For example arthritis, restricted mobility, anxiety, reduced hearing or sight. Handy hint.... click the + on the right hand side to add more rows!WhoCondition or things you may find harderHow can we support you? Add Remove The main dog you'd like support with: Please tell us about the main dog you want support with?(Required)click the + on the right hand side to add more rows!NameAgeBreedSexMedical ConditionsPlease tell us a bit about your dog - any relevant history, personality traits, what you feed etc Please tell us about the pets in your home: Please tell us about any other dogs in your home?click the + on the right hand side to add more rows!NameAgeBreedGenderMedical ConditionsNeuter StatusRescue (yes or no?) Add RemoveHow do the dogs get on with each other? Please tell us about any other pets in your home? Handy hint.... click the + on the right hand side to add more rows!NameSpecies Add RemovePlease tell us the level of interaction these other animals have with your dog and how they get on, where appropriate. your priorities to discuss in the session: Please tell us the most important thing we can help you with ...(Required)Let us know if there is anything else you'd like us to focus on if we have time (in order of priority)Handy hint.... click the + on the right hand side to add more rows! Add Remove Anything else? If there is any extra information that would be helpful for us to know, please add it here:
