Detailed Behavioural Assessment Questionnaire

Detailed Behavioural Assessment Questionnaire
Please complete & submit this form with as much detail as possible, so I have all the information I need about you, your dog and your lifestyle together in order to complete my review & assessment and formulate a suitable progress plan for you both.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
example@example.com
Your Preferred Contact Telephone Number*
Do you have any known health problems*

YesNo
If Yes please provide brief details here
Marketing Permissions*

EmailDirect MailCustomized online advertising
TELL ME ABOUT YOUR DOG
Your Dog's Name*
What size and breed or type is your dog*
IE - Small, Medium, Large & I appreciate most overseas dogs are mixed breeds, please include any possible breed types or characteristics your dog may have - ie Mioritic or Mioritic cross, Border Collie or BC Cross, Shepherd etc
Your dog's current age*
Sex*

Un-neutered MaleNeutered MaleUn-Spayed FemaleSpayed Female
What date/age was your dog neutered/spayed (if you don't know just type n/a)*
What date did your dog come to live with you*
From which rescue organisation was your dog adopted?*
Describe how your dog settled in over the first 3 months at your home (if they have been with you less than 3 months, describe the period they've been with you so far)*
Please provide details of your dogs history to date as far as you know - both in their country of origin & here in the UK. *
Included any known history from when they were found/rescued overseas, how many homes in the UK, if they have been an adoption return what was the reason etc
Has your dog had any negative experiences with anything/anyone or any kind of trauma in their past that you know of*
List your dogs 5 favourite things (e.g. cuddles, walks, playing chase, sleeping etc.)*
List your dogs 5 least favourite things (e.g. storms, fireworks, strangers, visitors, traffic etc.)*
What education / training has your dog had so far, what life skills do they have - e.g. sit, down, recall, leave it, hand touch, loose lead walking, impulse control etc. - & how were these taught - e.g. using positive reinforcement, luring, bribing, coercion etc*
Please include details of any aversive teaching methods like (spray bottles, jerking on the lead, E-Collars) that may have been used either by you or someone else in your dog's history. We are NOT here to judge anyone, it would just be helpful to know what experiences are in your dog's history so we can make the best plan for them going forward.
TELL ME ABOUT YOUR BEHAVIOUR CHALLENGES
BEHAVIOUR CONCERN 1 - Please provide details of the most pressing behaviour concern you would like to address *
List or describe the circumstances or triggers that provoke this behaviour*
Can you describe your dogs behaviour & body language in as much detail as possible when confronted with this trigger/circumstance - what do they do specifically*
Can you tell me what you do when your dog performs this behaviour - what is your response when it happens*
How many times a day is this behaviour happening*
How long does it take your dog to recover*

1-5 minutes5-15 minutes30 minutes or longerOther
Is there anything else about this behaviour concern you would like to mention or add - if nothing, just put n/a*
Have you previously consulted with a trainer or behaviourist about this problem*

YesNo
If so, please provide details of the individual training activities and exercises you were recommended by that trainer/behaviourist. Also include details of what has been effective in seeing results and what has not been effective. If not applicable, just type N/A*
BEHAVIOUR CONCERN 2 - Please provide details of the next most pressing behaviour concern you would like to address *
List or describe the circumstances or triggers that provoke this behaviour*
Can you describe your dogs behaviour & body language in as much detail as possible when confronted with this trigger/circumstance - what do they do specifically*
Can you tell me what you do when your dog performs this behaviour - what is your response when it happens*
How many times a day is this behaviour happening*
How long does it take your dog to recover*

1-5 minutes5-15 minutes30 minutes or longerOther
Is there anything else about this behaviour concern you would like to mention or add - if nothing, just put n/a*
Have you previously consulted with a trainer or behaviourist about this problem*

YesNo
If so, please provide details of the individual training activities and exercises you were recommended by that trainer/behaviourist. Also include details of what has been effective in seeing results and what has not been effective. If not applicable, just type N/A*
ADDITIONAL BEHAVIOUR CHALLENGES: Please add here details of any other behavioural challenges you wish to discuss/mention - If there are none, just put n/a*
Has your dog ever bitten anyone, if so please provide details of each incident below including the circumstances surrounding the bite and how severe the bite was. If not applicable, please just type N/A*
IE - Nipped at clothing, nipped and caught skin, caused bruising, broke the skin, puncture wounds etc
Check any of the following that exist or happen on a daily or regular basis*

Ignores youJumps UpDigsPulls on the leadDestructive behavioursSeparation Anxiety related behavioursRecall failureChasingShy or timid behaviourFollows you (or members of the family) around the houseFearful behaviourChewingMouthing or NippingDiarrhoeaHouse soilingExcessive BarkingHyperactivityGrowlingAggression toward peopleAggression toward other dogsGuarding behaviours - TerritorialGuarding behaviours - Resources
TELL ME ABOUT YOUR HOUSEHOLD
Please list all members of your household and their ages*
Who would you say your dog trusts most in the world. Who are they most comfortable with, most relaxed around, most responsive to etc *
If your dog has issues, is fearful or reactive toward anyone living in the same household, please provide details of those people here. If there are none, just type N/A*
Are there any other pets in the household*

DogsCatsOtherNo other pets
If there are other pets in the household, please provide brief details & ages here
Ho would you describe your household - e.g. Busy, hectic, rowdy, lots of comings & goings, quiet, calm, *
Tell me about the type of area you live in - e.g. inner city, large town, small town, fringes of town, village, rural/countryside etc.*
TELL ME ABOUT YOUR DOG'S HEALTH & DIET
When did your dog last visit a Vet & what was the visit for*
What is your dogs approximate current weight*
Does your dog have any known injuries, possible injuries or ongoing health issues*

YesNo
If Yes please provide details of the injury or health issues here - if none just put n/a*
If you don't know of any injuries but suspect your dog may have any because you've noticed things in the way they move or carry themselves, or they are sensitive to touch in certain areas, please include details here
Have you noticed anything that has made you wonder if your dog may be in pain - if not just put n/a*
Is your dog on any medication or supplements? If yes, please provide details here - if not just type n/a*
What Diet do you feed your dog - please include brand names & type - ie senior, hypoallergenic etc*
How do you feed your dog (check all that apply)*

Food BowlThroughout the day during trainingIn food toys & puzzles (likkimats, snufflemats etc)In Stuffed Bones or KongsMy dog is free fed (ie food is simply available in a bowl at all times)Other
What food treats do you usually use when training*
Please list details of any additional treats, chews, food items your dog has regularly in addition to their daily diet & training treats*
Is your dog food motivated*

Yes very loves their meals & treatsYes mostly - eats all his meals, but not always interested in food treatsYes at home but isn't interested in food on walksNot really - doesn't always eat all their meals, not always interested in food treatsNot at all - little interest in meals or food treats
How many times a day does your dog poop and what is it like. For example, two times a day, a large/small handful, usually firm / soft / loose & light / dark in colour *
You're almost there! Last Section!

Thank you for taking the time to provide all these details for me, it will definitely help set us all up for success! 😊
TELL ME ABOUT YOUR DOG'S DAY TO DAY LIFE
Please provide details of what your dog's daily routine looks like - What time they get up, eat, what time they go for walks/exercise, when they sleep/rest etc.*
I appreciate not every day may be exactly the same but if you can provide an idea of what your dogs daily routine looks like that would be helpful.
How much total exercise does your dog have each day (This can be walks or just at home/in the garden if your dog doesn't go on walks yet)*

0 - 30 minutes30 - 60 minutes1 - 2 hours2 hours +Other
How long are each of your dogs walks and in what type of locations. For example: AM walk - 30 minutes on lead street walk / PM walk - 1 hour off lead quiet countryside walk*
If your dog is not going on walks, please provide details of the activities you do with them at home or in the garden, what type, how long for etc
What type of equipment does your dog wear to go on walks - Collar/Lead/Harness etc. - please provide product names where applicable*
IE - Perfect fit Harness, flat collar, choke chain, semi choke collar, 6ft soft lead, Halti Head collar, 15ft training line etc If different equipment is used for different types of walks, please clarify this too.
Does your dog show any signs of aversion to having their walking equipment put on them *
Does your dog have regular opportunities to interact with other dogs (if this is something they enjoy)*

YesNo
Does your dog go to daycare? If so please provide the name of the daycare facility + how often your dog goes as well as for how long each time - if your dog doesn't go to daycare, just put n/a*
Do you have a dog walker that regularly walks your dog for you? If so please provide details of whether these are solo or group walks and how your dog is when out on walks with your dog walker - if not just put n/a*
How often do you play with your dog on an average day (this can include play on walks but must be interactive play or activities with you - not just you walking your dog)*

I don't play with my dog10 minutes per day30 minutes per day1 hour per dayOther
Describe how you play with your dog *
What would you say are your dogs favourite games / things to play with you (e.g. chase games, hide & seek games, hunting games, rough & tumble games etc.)*
Do other household members play with your dog - if so, describe what games they play, are they the same as with you or different?*
If not applicable please just type N/A
Is your dog toy motivated, if so please provide details of toy preferences in order of most favourite to least favourite*
If not applicable please just type N/A
How many hours of rest and/or sleep do you feel your dog gets each day. Please split between night & daytime *
EG - 8 hours sleep at night, 3 hours sleep during the day, 1-2 hours resting during the day but not sleeping etc
Where does your dog sleep at night*
Where is your dog left when you go out during the day*
Do you have any space management in place at home. ie baby gates separating rooms, or preventing your dog from gaining access to certain areas of the home*
How often does your dog have enrichment activities*

DailyEvery couple of daysTwice a weekOnce a weekOccasionallyNeverOther
What type of enrichment activities does your dog enjoy? Which would you say are their absolute favourites*
IE - Stuffed Kongs or bones, likkimats, snufflemats, snuffle boxes, scatter feeding, scent trails, hidden treats etc
What type of enrichment activity do you feel helps your dog be more calm & relaxed*
Is your dog happy to wear a muzzle*

No we haven't done any muzzle conditioningYes my dog will wear a muzzle but isn't overly happy about itNot yet, but we are working on itYes I have done muzzle conditioning & my dog is happy wearing a muzzle
Is your dog crate trained*

Yes but they don't really like being in a crateYes and they love being in their crateNo my dog hates being in a crateNo this isn't something we've tried
Does your dog have any unique quirks or preferences that you have noticed, if so please provide details here, if none please just type N/A*
How did you hear about The DOG's Point of View*

Google SearchFacebookYouTubeRecommended by friendRecommended by another trainerRecommended by rescue organisationThe Dog's Point of View WebsitePet Professional Guild WebsiteOther
May we use any photos/videos of you and/or your dog taken during consultations or provided by you on our website and/or in marketing and online tutorial materials?*

Yes that would be fineNo thank you, I would rather you didn't
If there is anything else you would like to add, please do so here
Thank you for completing the detailed pre-consult questionnaire, once you hit submit all your information will be emailed to me and once I have your video files I will review all the information and formulate your initial progress plan. If I require any further information from you, I will be in touch.

If you have any questions please do not hesitate to email me at michelle@thedogspov.com.

Speak Soon :)

Kind Regards

Meesh

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Disclaimer: By completion of this form you understand that the participation in a dog training session, consultation or class may pose some risk to yourself, your dog, members of your family, or visiting guests and you assume the risk of any damage or injury incurred in attending such sessions conducted by The Dogs Point of View.

Whether we work in person or remotely you agree to minimize all risk by fully disclosing any danger or sensitivities your dog may present with and will immediately inform the trainer of any situations that may provoke aggression in your dog and be responsible for avoiding or preventing those situations.

In aggreeing to participate, you agree that yourself and any minors attending the dog training session/s or consultations with us, whether in person or via remote video consultations, waive, release, and agree to hold harmless The Dog's Point of view and any and all of its trainers and volunteers from any and all causes of actions, claims, demands, losses, injuries, and damages of any kind which may be sustained by you or your dog/s in connection with the dog training session.

You understand that you shall be responsible for and indemnify and hold harmless The Dog's Point of View and its trainers, volunteers and representatives from and against all claims, damages, costs and liabilities in respect of any loss, damage or personal injury sustained by you or any third party which is directly or indirectly caused by your dog.
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Detailed Behavioural Assessment Questionnaire

TELL ME ABOUT YOUR DOG

TELL ME ABOUT YOUR BEHAVIOUR CHALLENGES

TELL ME ABOUT YOUR HOUSEHOLD

TELL ME ABOUT YOUR DOG'S HEALTH & DIET

TELL ME ABOUT YOUR DOG'S DAY TO DAY LIFE