Behavioural Consultation pre-visit questionnaire
Please answer the following questions to the best of your ability. Your answers will help us to understand your pet better and allow us to formulate a more personalised behavioural treatment plan.
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
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1. Where did you get this pet?
2. Has it had any previous owners? How many?
3. Why was the dog rehomed? (if applicable)
4. Have you had other pets prior to this one?
5. Why did you choose this particular animal/ breed?
6. How old was this animal when you acquired it?
7. Did you see the littermates? Please describe your pet’s behaviour compared to the littermates. Why did you pick this one?
8. Did you meet your pet’s parents? If so, please describe their behaviour.
9. Please describe your pet’s behaviour as a puppy/ kitten. Were they playful? shy? destructive? anxious? The more details the better.
10. Is your pet house trained/ litter trained? Did you house train/ litter train your pet?
11. Does your pet ever eliminate in the house? (outside of the litter tray) Where? How often?
12. Please list all the people, including yourself, in your household. Briefly describe each person's relationship with the animal/ how they are involved with the animal's care.
13. Please list anyone else involved in the care of this animal (trainers, neighbours, pet sitters etc).
14. Please list all the animals in your house and include the following; name, age, species, breed, age, sex and whether they are desexed. Please list the animals in order in which you adopted them, from oldest to most recent.
15. What is your pet’s relationship to all of the other animals in the home? (friendly, aggressive, fearful etc)
16. How would you describe your relationship with your pet?
17. Is there anything that adversely influences your ability to interact with your pet?
18. What area do you live in? (City, suburbs, rural).
19. Do you rent or own your home? (this will help with any environmental changes we might suggest)
20. Do you have a yard? Roughly how big is it?
21. Have you moved since acquiring this pet? How many times? How recently?
22. How did your pet cope with this move?
23. Has your household changed (people and/ or animals) since acquiring this pet? Please give details
23. How many times per day is your pet fed? Where do they eat? Who feeds the pet?
24. What do you usually feed your pet?
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25. Please describe a typical 24 hour day in your pet’s life
26. Where does your pet sleep at night? (be specific)
27. Are they inside the house when you are out? If so, do you know what they do when you are out?
28. How does your pet behave when you have guests? How do they react to familiar visitors vs unfamiliar visitors?
29. How does your pet behave when you leave the house?
30. How does your pet behave when you get home?
31. How does your pet react to thunderstorms, fireworks, and other loud noises? Are there any noises in particular that upset them?
* Dogs Only * Does your dog jump up on you without permission?
Yes
No
- Does your dog jump up on other people without permission?
Yes
No
- Does your dog paw at you?
Yes
No
- Does your dog paw at other people?
Yes
No
- Does your dog lick you?
Yes
No
- Does your dog lick, bite or groom himself excessively?
Yes
No
- Does your dog mount people?
Yes
No
- Does your dog mount other dogs
Yes
No
- Does your dog ever bark at you?
Yes
No
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* This section is cats only, click passed for more dog questions * Does your cat lick you?
Yes
No
- Does your cat groom, lick or bite himself excessively?
Yes
No
- Does your cat mount people, cats or other animals?
Yes
No
1. Toileting history - Does your cat use a litter tray?
2. Is the tray covered or uncovered? Roughly what size is it?
3. How many litter trays are in the house? Where are they placed?
4. What litter substrate do you use? Have you changed this recently?
5. How often do you empty the litter tray?
6. How often do you thoroughly clean the litter tray?
7. Does your cat cover/ bury their faeces and urine?
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1. This section is dogs only, click passed for more cat questions - What basic training has your dog had ? (eg puppy school, obedience classes etc)
2. Please list the names and qualifications of the trainers (if known).
3. Who is the primary trainer in the household?
4. What sort of collar or harness do you use when walking or training your dog?
5. Does your dog know any tricks?
6. Do you play with your dog? How do you play?
7. What toys does your dog have? Do they have a favourite?
8. Does your dog play fetch?
9. Please describe your dog’s daily exercise routine including time spent on each activity (eg leash walks, supervised vs unsupervised play at the dog park, unsupervise time in the yard, playing at home)
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All other questions are for dogs and cats - Medical History - 1. At what age was your pet desexed? Why was this done?
2. Did you notice any behavioural changes after desexing?
3. If your pet has not been desexed - Have you bred this animal? - Do you plan to? - If female - when was she last on heat?
4. Has your dog had any medical problems in the past? What were they? What treatments were used?
5. Does your dog have any current medical problems? Please list any medications or supplements your pet is currently taking.
6. Is your pet currently on any medications, natural remedies or supplements for behaviour problems? Please list them
7. What response (if any), have you noticed with each of the above medications/ supplements?
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Primary Behavioural Concerns - 1. Why are you seeking help/ advice about your pet?
2. What is the main behaviour problem/ issue?
3. Why is the behaviour a problem?
4. Please list any other problem behaviours. Why are these behaviours a problem?
5. How frequently does each problem occur?
6. When did you first notice the main problem? How old was your pet at this time?
7. Please describe how the problem(s) have developed over time. Have they changed in frequency? Intensity?
8. When did this problem become a serious concern? Why?
9. In what circumstances does your pet tend to exhibit these problem behaviours?
10. Please describe each of the last 3 incidents of problem behaviours in as much detail as possible
11. What have you done to try to correct the problem so far? (i.e. use of a trainer, discipline techniques, training at home etc)
12. How did your pet respond to this?
13. Do you feel at all responsible for your pet’s behaviour? Why?
14. What are your goals for treatment?
15. Do you feel these goals are achievable? Why?
16. Do you have any other questions or information that you feel might be relevant?
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