Dog Behaviour History Form

Please select the type of consultation you are looking for:

In Person Behaviour Consultation (Berkshire and North Hampshire)Video Behaviour Consultation (Remote, Worldwide)

Client/Owner Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

Post code

Phone Number*

Area CodePhone Number

E-mail*

Dog's name*

Dog's breed (or closest guess)*

Neuter Status (& approximate date of procedure)*

Dog's age (or closest guess)*

Dog's weight (kg)*

Dog's gender*

MaleFemale

Veterinary Practice Name*

Vet Address

Vet Contact Number or Email*

Behaviour Consultations may require access to your dog's Veterinary Clinical History. Do you consent to us getting in touch with your vet to forward an up to date history? Alternatively, you can ask your vet for a copy and email it to us.

Yes

Do you consent to us posting a photo of your dog on our social media?*

YesNo

How did you hear about us/find us?*

Is the dog completely physically healthy according to the veterinarian? If not, please list any known/ongoing health issues (including allergies) & medication taken?*

When was the dog's last vet appointment and what was the reason for it?*

What type of food does your dog eat for main meals? Tick all that apply*

RawCooked (inc. home cooked)Wet (e.g. tins/pouches)Dry

What brand of food does your dog eat for main meals?*

How are your dog's main meals currently fed? Tick all that apply*

In a standard bowlIn a food toy (kong, puzzle bowl, snuffle mat etc)Hand fedFed during training

How many set meals does your dog receive per day?*

None - Free fed (bowl is left out)1 main meal2 main meals3 or more main meals

What is your dog's appetite level?*

Eats everything, not pickyEats treats, picky with mealsCan turn down most mealsCan turn down most treats

Does your dog ever have issues with ill-formed stools?*

Never, stools are always solidRarely, only if they eat something bad/newOften, has ill-formed (soft) stools at least a few times a weekUsually, stools may be soft at least once a day

What type of physical exercise does your dog receive on an average day? Tick all that apply*

How much physical exercise does your dog receive on an average day?*

Less than 30 minutes30 minutes - 1 hour1 hour - 2 hours2 hours +

What type, if any, of mental stimulation does your dog receive on an average day? Tick all that apply*

How much mental stimulation does your dog receive on an average day?*

NoneLess than 10 minutes10 minutes - 20 minutes20 minutes +

Is your dog motivated to work for any of the following? Tick all that apply*

Toys - ChasingToys - TuggingToys - SearchingTreats - High Value (e.g. cooked meat)Treats - Medium Value (e.g. store bought treat)Treats - Low Value (e.g. kibble, fruits, veggies)Not motivated by any of the above

Is the dog ever crated? (Shut inside crate). If yes, for how long?*

What is the dog's reaction to being groomed? (Brushed, trimmed etc)*

Is the dog comfortable being formally handled by a trusted person? E.g. health checks including ears, eyes, teeth, legs, tail, abdomen and back. Does the dog have any sensitive areas?*

Has the dog ever had any formal training from an external trainer/behaviourist? If yes, what were you trying to acheive and what was the outcome?*

What type of training has been/is currently used with the dog? E.g. rewarding good behaviour, telling off, time out, ignoring?*

What type of equipment has been/is currently used with the dog? E.g. specific collars, harnesses, clicker, whistle, leads*

How long have you had the dog?*

Where did the dog come from? E.g. rescue centre, registered breeder, online sale*

If you haven't had the dog since 8 weeks, do you have any history about the dog from the previous home/rescue?

Roughly how many hours of sleep does the dog get per 24 hour period?*

Where does the dog sleep during the day and at night?*

Are there any other animals living in the environment or visiting regularly (once a week minimum)? If yes, how does the dog behave around them?

Have there been any environmental changes in the last 12 months? E.g. moving home, new household members, previous household members leaving, other animals?

Describe the problem behaviours you would like to address*

Has the dog ever bitten another person or dog? (Bites include any behaviours with the mouth which caused marks or punctures with INTENT. Please do not include non intentional bites, such as puppy mouthing or accidental nips during play)*

Yes, A PersonYes, A DogNo

When did the issues begin?*

Describe the dog's general behaviour at home when you/the family is around. E.g. relaxed, excitable, stressed, depressed.*

Unless described above, is the dog ever left alone? If yes, for how long?

Unless described above, how does the dog behave when left alone?

Unless described above, how does the dog behave when seeing other dogs?

Unless described above, how does the dog behave when seeing unknown people both at home and on walks?

Unless described above, how does the dog behave when seeing wildlife, cars, bikes, scooters, strollers etc?

Terms & Conditions for Bookings

Prices are subject to change at our discretion however we will always honour the price you have been quoted for up to one month within being quoted.
Payment is payable at the time of booking(s) to secure the slot(s).
Recurring weekly walking slots can be paid monthly at the start of the month (1st) or weekly on each Sunday of the month. Invoices avaliable on request.
Pet Sitting Services require a 50% non-refundable deposit at the time of booking to secure the dates, with the remainder being paid on the first day of the sitting.
Behaviour Consultations require a £30.00 non refundable deposit at the time of booking to secure the slot, with the remainder due on the day of the consultation.
Package bookings must be paid as a whole in order to receive the discount.
Payments 3 or more days late will incur an additional late fee charge of £5.00 per day.
Cancellation policy for Behaiour, Training & Walking: sessions cancelled by the client with less than 48 hours before the start of the service will be charged at full price.
Recurring weekly slots will be held for each client indefinitley, if 2 or more slots are skipped without 30 days notice, the slot may be withdrawn.
If a walking session is rescheduled by us with less than 7 days notice, clients are entitled to a full refund.
If a pet sit is cancelled by us, clients are entitled to a full refund
A fuel surcharge of 30p per mile will be added for Walking & Pet Sitting located more than 6 miles outside of GU9
The Positive Canine uses Positive Reinforcement methods, and no aversive methods will ever be recommended or accepted for training. We are more than happy to discuss this in more detail to explain the reasoning behind our choices. We are happy to help clients change over from aversive training methods into force free methods. Aversive training methods include: choke chains, pet corrector, spray bottles, prong collars, E collars or physical or psychological intimidation.
All dogs undergoing training sessions must be controlled by an adult over 18, however children are welcome to attend to observe and take part in appropriate sessions.
We may require the dog to undergo a veterinary health check prior to proceeding with training and behaviour modification; this is because underlying medical conditions can affect behaviour. This helps not only your dog, but also ensures the training is effective.
The Positive Canine does not claim to resolve all issues within a few sessions, especially more complex issues such as reactivity, separation anxiety or resource guarding. Results will also depend on how long the issues have been occurring for. We aim to give our clients the necessary knowledge and tools to continue the training outside of training sessions.

We have found that some email responses may end up in a junk/spam folder. Please check junk folders regularly whilst awaiting a response. Thank you.

I Agree to the Terms and Conditions listed above*

Yes

Dog Behaviour History Form

Dog Behaviour History Form

Health & Lifestyle

Exercise

Grooming & Handling

Training History

Environmental & Additional Information

The Dog's Behaviour