Behavioural Consultation

Pre - Consultation History Gathering

Before your behaviour consultation we ask that you provide us with the following information. We understand that this form may seem lengthy, however we need to gain as much information as possible to help us to get an understanding of your dog and your situation before the consultation takes place. The information you provide will be used to help with our assessment and the treatment plan we design. This form should be completed by the person who spends most time with the dog. Please discuss your responses with the whole household. Please include as much information as possible.
Your details
Full Name
Address
Post Code
Email address
Telephone Number
Alternative Number
List all members of household, relationship to you, and age (including other pets)
Your pet's details
Animals Name
Sex and Neuter status

Male EntireMale NeuteredFemale EntireFemale Spayed
Reason for neutering/not neutering, any behaviour change on neutering
Briefly describe the behaviour problem/s you are experiencing
At what age did the dog come to you, and where from?
What do you feed your dog?
Any additional supplements/herbal etc?
Do they enjoy their food or can they be fussy?
Do you feed treats? How often/when
Do you feed bones/chews?
Is there any aggression around food

NoYesDon't Know
Describe a typical day for your dog
Describe type of exercise/how long/where etc
Does your dog play and have access to toys?
What is your dogs favourite game?
Describe what training you have done with your dog,
Do you (or a professional) groom your dog? How do they respond.
About the behaviour problem
When did the behaviour problem begin
Describe the first incident you can remember
Describe the most recent incident
Describe any other behaviour problems you have with this pet (however small)
Describe how your dog behaves when visiting the vets?
How does your dog behave in the following circumstances
With familiar dogs on property

CalmFriendlyExcitedAmbivalentFearfulAggressive
With familiar dogs off property

CalmFriendlyExcitedAmbivalentFearfulAggressive
With unfamiliar dogs on property

CalmFriendlyExcitedAmbivalentFearfulAggressive
With unfamiliar dogs off property

CalmFriendlyExcitedAmbivalentFearfulAggressive
With unfamiliar people on property

CalmFriendlyExcitedAmbivalentFearfulAggressive
With unfamiliar people off property

CalmFriendlyExcitedAmbivalentFearfulAggressive
With unfamiliar people at the door

CalmFriendlyExcitedAmbivalentFearfulAggressive
With children

CalmFriendlyExcitedAmbivalentFearfulAggressive
Thunderstorms/ Fireworks

CalmFriendlyExcitedAmbivalentFearfulAggressive
Other loud noises

CalmFriendlyExcitedAmbivalentFearfulAggressive
Busy areas/pubs etc

CalmFriendlyExcitedAmbivalentFearfulAggressive
With bikes/prams/ scooters etc

CalmFriendlyExcitedAmbivalentFearfulAggressive
Car travel

CalmFriendlyExcitedAmbivalentFearfulAggressive
Final details
What would your desired outcome be?
What would happen if we could not solve the problem?
If there is anything you would like to add please do so here.
If possible, please upload a favourite picture of your pet

Cancelof
I agree to the terms and conditions displayed on the website (also can be sent via email)
Thank you for completing this information

It will be used to guide discussions to make sure we get the best out of our consultation.
Should be Empty:

Pre - Consultation History Gathering

Your details

Your pet's details

About the behaviour problem

How does your dog behave in the following circumstances

Final details

Thank you for completing this information