Dog Behaviour Questionnaire

Date

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Dog's Name*

Breed*

Age*

Sex*

Pet Neutered?*

If so, when was it done*

How old was your dog when you obtained it?*

Can you remember where he/she came from?*

Was s/he rehomed or from a rescue centre?*

Why was s/he rehomed?*

What do you feed him/her?*

When do you feed him/her?*

How many times a day is s/he fed?*

Do you give any supplements, e.g. Vitamin pills?*

Does s/he enjoy food or are they finicky?*

Do you give any titbits? If so,what?*

What type of exercise does your dog have?*

How many hours of exercise per day?*

Does s/he tend to be alone or with other dogs? Do you keep your dog on a lead, or allow them to run loose?*

Do you keep your dog on a lead, or allow them to run loose?*

Does s/he tend to be alone or with other dogs?*

Does s/he enjoy their walks?*

Is there any interaction/play with other dogs?*

What is your dog's favorite toy?*

What is your dog's favorite game with people?*

Does your dog have free access to them?*

Where do you keep your dog's toys?*

Where does your pet sleep at night?*

Where does s/he stay when you go out?*

Is s/he left regularly? If so, for how long?*

Do you leave any toys or other distractions?*

If so, What happens?*

Are there any problems when you leave him/her?*

Is there access to the garden?*

When you are at home, does your dog tend to follow you around the house?*

Have you attended training classes with your dog? how old was the dog at the time?*

How long did you attend for?*

Where there any problems with the training?*

Can you remember how you toilet trained the dog? please describe.*

Come when called?*

Does s/he walk to heel?*

Drop objects when asked?*

what other cues does your dog know?*

How many people are there in your household?*

Are there any children? If so, how old are they?*

Does everybody interact with the dog?*

Do you have any other animals (type, age, sex)*

Do you know of any previous medical problems?*

Does your dog have any current medical problems to your knowledge?*

Is s/he on any current medication?*

Describe the problems you are having with your dog in as much detail as possible *

What happens immediately before your dog displays these behaviours? Try to think both what you and your dog are doing when the problem occurs.*

Try to think both what you and your dog are doing when the problem occurs.*

What happens immediately after? Again, think about what you do, and what the dog does.*

When did the problem begin? Can you remember the first time it happened?*

When does the problem occur? Is it in any particular circumstance?*

Do you think it is becoming more frequent, less frequent, or staying about the same?*

Where does it occur? Is it for example, always in the same place?*

Who is usually present at the time?*

When was the last incident, and can you describe this?*

If your dog is an entire bitch, is the behaviour related to her season, or does it change during her season?*

Do any related dogs have similar problems?*

Do any dogs in contact with it have similar problems?*

Have there been any previous attempts to cure this problem? (if so, please describe)*

Does your dog have any other problems?*

With children?*

When meeting other dogs?*

When you feed them?*

With loud noises? When meeting other dogs?*

Would you describe your dog as:

A fussy feeder?*

Aggressive in any situation?*

Aggreesive to other dogs?*

Nervous of anything, such as strangers or loud noises?*

Bouncy and enthuslastic?*

Socialable?*

Confident?*

Does your dog enjoy being groomed? What kind of of brush do you use?*

UO you need to sedate nim/ner wnen you go to the vet, or for clipping nails?*

Is this your first dog (not including childhood pets)?*

If not, what breeds of dog have you owned previously?*

How much time do you feel able to commit to working with your dog to solve these problems*

What would you envisage happening if the behaviour problems persists?*

Thank you very much for your co operation in filling in this questionnaire. If you have any queries please contact (07707) 219 437