Behaviour Questionnaire

Behaviour Questionnaire

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:

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?

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?

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?
Should be Empty: