Behaviour Intake Questionnaire

Behaviour Intake Questionnaire

This form is designed to collect important background information about your dog ahead of our behaviour consultation. The details you provide will help us better understand your dog’s history, environment, daily routine, and specific behaviour concerns, so we can tailor our approach and support plan to suit their individual needs. Please complete the questionnaire as fully and honestly as possible before your first session.
Client/Main Guardian Full Name*

First NameLast Name
If outside the UK, please share your current time zone (to ensure we can effectively plan support call sessions)
Weekday AMWeekday PMWeekend AM (please note weekend slots are limited and may result in longer wait time)
E-mail*
Contact Number (a number associated with WhatsApp preferred)*

Area CodePhone Number
Address (In Person Sessions Only)

Street Address

Street Address Line 2

CityState / Province

Post code
Dog's Name*
Dog's Breed (or closest guess)*
Male, EntireMale, NeuteredFemale, EntireFemale, Neutered
Dog's Date of Birth (or closest guess)*
Dog's Weight (kg - or closest guess)*
How long has the dog been in your primary care?*
Where did the dog come from? E.g. rescue centre, breeder, online sale, friend/family rehome:*
Veterinary Practice Name*
Veterinary Practice Location/Town*
YesNo
YesNo
How did you hear about us/find us?*
Health & Lifestyle
Is the dog completely physically healthy to your best knowledge? 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?*
Roughly how many hours of sleep does the dog get per 24 hours?*
Where does the dog sleep at night and during the day?*
RawCooked (inc. home cooked)Wet (e.g. tins/pouches/trays)Dry
What brand of food does your dog eat for main meals? (If multiple, please list all or most recent)*
In a standard bowlIn a food toy (kong, puzzle bowl, snuffle mat etc)Hand fedFed during training
None - Free fed (bowl is left out)1 main meal2 main meals3 or more main meals
Eats everything, not pickyEats treats, picky with mealsCan turn down most mealsCan turn down most treats
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
Exercise
Running or Walking Off LeadAgilityRunning On Lead e.g. CaniCrossSwimmingPavement Walking On LeadPark/Field/Woodland Walking On LeadNone/Garden OnlyToy Play (e.g. Tug, Chase)
NoneUp To 30 minutes30 minutes - 1 hour1 hour - 2 hours2 hours +
NoneTrick TrainingScent Work / Search GamesPuzzles / Food EnrichmentAgility / HoopersOther
NoneLess than 5 minutes5 - 10 minutes10 - 20 minutes20 minutes +
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 per 24 hours?*
Grooming & Handling
What is the dog's reaction to being groomed by you/their primary guardian? (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?*
Does the dog ever visit a professional groomer? If yes, how do they react?*
How does the dog react to handling by an unknown person? e.g. health check by a veterinary surgeon*
Training History
Has the dog ever had any formal training from an external trainer/behaviourist? If yes, what were you trying to achieve 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*
Environmental & Additional Information
If you haven't had the dog since 8 weeks, do you have any history about the dog from the previous home/rescue?
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?
The Dog's Behaviour
Describe the problem behaviours you would like to address in detail *
When did the issues begin?*
Yes, A PersonYes, A DogYes, another animalNo
If yes to the above question, please explain the circumstances surrounding each bite incident. Please also describe the severity of the bite and what treatment was required.
Describe the dog's general behaviour at home when you/the family is around. E.g. relaxed, excitable, stressed, depressed.*
Unless described above, how does the dog behave when left alone, and how long are they left alone for per day?
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?
Is there anything else you think is worth mentioning?
By clicking submit, you agree to the terms and conditions outlined on www.wholedogbehaviour.com/termsandconditions
Should be Empty:

Behaviour Intake Questionnaire

Health & Lifestyle

Exercise

Grooming & Handling

Training History

Environmental & Additional Information

The Dog's Behaviour