Behavior Consultation Pre-Screening
We are here to help! Please fill out the follow behavior consultation pre-screening questionnaire to the best of your knowledge. We will reach out to schedule your consultation after review which can take 48-72 hours.
Primary Dog Parent Name
*
First Name
Last Name
Primary E-mail
*
example@example.com
Primary Phone Number
*
Please enter a valid phone number.
Secondary Dog Parent Name
First Name
Last Name
Secondary Email
example@example.com
Secondary Phone Number
Please enter a valid phone number.
Dog Name
*
Dog's Breed
*
(or best guess)
Dog's Birthday
*
-
Month
-
Day
Year
(or best guess)
Where did you get your dog?
*
Breeder, rescue, pet store, family friend, etc.
When did you bring your dog home?
*
-
Month
-
Day
Year
Date
Is your dog already a patient of Paw Patch Place?
*
Does your dog show any of the following behavior?
*
Showing their teeth when threatened
Guarding food, toys, people, or spaces
Growling when threatened
Barking, lunging, pulling towards dogs, bikes, people, cars on leash
Play biting/mouthiness
Destructive towards the house
Destructive when owner is away
Reluctance to being handled
Fear of nail trims or grooming
Aggressive behavior towards people
Aggressive behavior towards dogs or other animals
Housesoiling
Fear of Car rides
Other
Briefly describe your dog's behavior in detail:
*
Be objective and describe the behavior. Avoid using labels such as "aggressive" but instead characterize what that behavior looks like (growling, lunging, etc).
Has your dog had training before? If so, with whom?
*
Please check here if you or anyone in your household has a peanut allergy:
Myself or someone in my household has a peanut allergy
What is your general availability for sessions?
Example: Mornings, evenings, Fridays, etc.
Submit
Should be Empty: