Temperament Evaluation Interview Form

Temperament Evaluation Interview Form
Date*

MonthDayYear
Date
Parents First Name*
Last Name*
Dog’s Name*
Breed*
Age*
Birthday
MaleFemaleNeuteredSpayed
YesNo
If you plan on Spay/Neutering, when?
PET HISTORY
When & where did the parent get the pet?*
•Any major medical issues?*
•Any food or skin allergies?*
PET PERSONALITY
•Behavior when meeting new person or pet?*
•Behavior when playing with other pets or*
Behavior around food? (possessive or guarding)*
• Does your dog’s Behavior change when in a small area or feeling cornered?*
Big Dog OnlySmall dog onlyAll DogsOtherSelect if allowed to have treats while at K9 KampusSelect if NOT allowed to have treats while at K9 Kampus?

PET EXPERIENCES

Rows	Yes	No	If Yes, describe.
•Ever shown aggression towards people or other animals? (bitten, showed teeth, growled)
•Has ever had a traumatic experience? (been bitten/attacked, abused, neglected)
•Have any phobias? (thunder, loud noises, clapping, yelling, fireworks, mailman)
• On flea/tick preventive?
•Ever been dismissed/kicked out of a daycare or boarding/kenneling facility?

YesNo
•If yes please list all places where your dog has attended daycare services.
YesNo
•If yes please list where you dog has played with other dogs. (i.e dog park, daycare)
YesNo
If yes please list where your dog attended training classes.
YesNo
If yes please list where your dog has boarded/kenneled before.
YesNo
YesNo
YesNo
YesNo
YesNo
If your dog has destroyed personal or household items please list those items:
YesNo
•If yes, please list other animals
Parent Signature*

Clear
Should be Empty: