Behaviour Questionnaire
General Infomation
Owner's Name:
Phone Number:
Email Address:
Address Line 1:
Address Line 2:
Postcode
Dog's Name:
Breed:
Gener Neuter Status:
Age When neutered:
Age:
Date of Birth:
Travel?
Vaccination History:
Flea and Tick Prevention
Does you dog have any physcial problems that your vet has noted?
Is your dog currently on any medication for any medical problem?
Diet:
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General Information
Do you have other pets in the household and do they have any behaviour problems?
Do you have other people living in the household and what are their relationships with the dog?
Origin Information
Age when acquired:
From where:
How many previous owners:
Have you met the parents:
How many puppies were in the litter?
How were puppies/individual kept?
Are any litter mates affected with any medical problems?
Why did you choose this specific puppy?
Are you in touch with owner's of littermates?
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Activity Infomation
Exercise
How many training sessions/day:
How many walks/day:
How many play sessions/day
What is your dog doing between these activities:
How is your dog kept when you leave them alone:
How many hours per day (daytime) does your dog spend alone:
How many hours per day (daytime) does your dog spend in a crate:
Where does your dog sleep?
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Training Information
What is your dog's foundation training history?
What is your dog's sports training history?
Would your dog do the following more than 80% of the time in the following places (select for yes)
Rows
At Home
On A Walk
In a New Place
Sit
Down
Recall
Nose Target
Loose-lead Walking
Toy Play As Reward
Taking Food As Reward
What tricks/cued behaviour does your dog know?
Which of these get them excited and which of them are calming?
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Sepration Information
What do you do in preparing to leave the house?
What does each dog do in response to this?
Does the dog in question do any of the following when left alone?
Destructive behaviour
Toileting
Vocalising
Salivating
Pacing
Panting
Refuse food/treats
Drinking
Hide/Escape
Tremble/Shake
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Noise Responce Infomation
In response to any of the following loud noises:
Thunder
Fireworks
Gunshots
Vehicles
Other domestic noises (washing machine/dishwasher etc)
Does you doig do any of the following behaviours:
Salivate
Toilet
Hide
Escape
Destroy
Freeze
Pant
Pace
Refuse Food/ Treats
Bark/ Growl
Lunge
Yawn
Chase
Snap/Bite/Aggress
Tremble/Shake
Seek Out People
How often do the noises occur?
Do any of your other pets have behavioural responses to noises?
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Dog-Human Struggle Information
In response to adults or children, does your dog do any of the following behaviours:
Salivate
Toilet
Hide
Escape
Destroy
Freeze
Pant
Pace
Refuse Food/ Treats
Bark/ Growl
Lunge
Yawn
Chase
Snap/Bite/Aggress
Tremble/Shake
Seek Out People
What specifically triggers this response?
How often does your dog encounter them?
Do any of your other pets have behavioural responses to people?
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Dog-Dog Struggle Information
In response to adult dogs or puppies, does your dog do any of the following behaviours:
Salivate
Toilet
Hide
Escape
Destroy
Freeze
Pant
Pace
Refuse Food/ Treats
Bark/ Growl
Lunge
Yawn
Chase
Snap/Bite/Aggress
Tremble/Shake
Seek Out People
What specifically triggers this response?
How often does your dog encounter them?
Do any of your other pets have behavioural responses to people?
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Resource Guarding Information
In response to a person or dog approaching them when they have a resource (something they value, e.g. food or toy), does your dog do any of the following behaviours:
Salivate
Toilet
Hide
Escape
Destroy
Freeze
Pant
Pace
Refuse Food/ Treats
Bark/ Growl
Lunge
Yawn
Chase
Snap/Bite/Aggress
Tremble/Shake
Seek Out People
What specifically triggers this response?
How often does your dog encounter them?
Do any of your other pets have behavioural responses to people?
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Struggle History
What is the problem?
When did it first occur?
Did it occur suddenly or develop slowly over time?
Has it progressed?
Is the problem always present?
If you want to give any more details please do below
Treatment History
What has been tried to resolve the problem?
Submit
Should be Empty: