Temperament Evaluation Interview Form

Temperament Evaluation Interview Form
Date *

Month Day Year
Date
Parents First Name *
Last Name *
Dog’s Name *
Breed *
Age *
Birthday
Sex/Status

Male Female Neutered Spayed
If dog is intact do you plan on Spay/Neutering

Yes No
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? *
• Parents Play Area Preferences

Big Dog Only Small dog only All Dogs Other Select if allowed to have treats while at K9 Kampus Select if NOT allowed to have treats while at K9 Kampus?

PET EXPERIENCES

	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?

HAS DOG EVER: Attended a daycare facility?

Yes No
•If yes please list all places where your dog has attended daycare services.
HAS DOG EVER: Played with other dogs?

Yes No
•If yes please list where you dog has played with other dogs. (i.e dog park, daycare)
HAS DOG EVER: Attended a Training Course?

Yes No
If yes please list where your dog attended training classes.
HAS DOG EVER: Boarded/Kenneled before?

Yes No
If yes please list where your dog has boarded/kenneled before.
Has your dog been kennel or crate trained?

Yes No
Has your dog showed signed of being food/water bowl possessive?

Yes No
Has your dog jumps for climbs fences?

Yes No
Has your dog shown signed of separation anxiety?

Yes No
Has your dog destroyed personal or household items?

Yes No
If your dog has destroyed personal or household items please list those items:
Do you have other animals in the household?

Yes No
•If yes, please list other animals
Parent Signature *

Clear
Should be Empty: