• Behavior Assessment - Canine

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  • Overview

  • Format: (000) 000-0000.
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  • Acquisition & Early History

  • How did you acquire this dog?*
  • If there were aggressive behaviors, what was the result to the victim? (Check all that apply)*

  • Medical History

  • How would you describe your dog's appetite? Select all that apply.*
  • Rows
  • From the list below, please check any ailments your pet has experienced within the last year.*
  • Does your pet have a relationship with any of the following veterinary specialists?*

  • Household & Daily Life

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  • In what sort of home do you and your pet reside?*
  • How would you describe the energy in your home?*
  • Have you owned a dog in your adult life prior to this one?*
  • How do you feed your dog?*
  • Do you need to be present for your dog to eat?*
  • Is your dog protective of their food?*
  • Do you have a yard? If yes, check all that apply:*
  • Does your dog run and bark at the fenceline?*
  • What type of physical exercise does your dog get on a regular basis?*
  • Is your dog playful?*
  • Is your dog affectionate or cuddly?*
  • Does your dog like to chew?*
  • Do they ever destroy their toys?*
  • Any inappropriate chewing?*
  • Do you record or monitor your pet when they are home alone?*
  • Does your dog exhibit any of the following behaviors as you are preparing to leave or once you are gone?*

  • Training & Learning History

  • How would you describe your dog's ability to learn?*
  • Is there any specific time devoted to training each day?*
  • Have you ever attended any professional, group classes?*
  • Have you ever worked with a private trainer?*
  • Has your dog ever gone to a board and train facility?*
  • Have you ever met with a veterinary behaviorist, animal behaviorist, or other behavior consultant?*
  • Which cues or commands does your dog respond to reliably?*
  • Does your dog pull on the leash?*
  • What training aids are you CURRENTLY using?*
  • What training aids have you used PREVIOUSLY?*

  • Miscellaneous Behaviors

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  • Any urination or defecation when the family is home or away?*
  • Any distress associated noises, storms, or fireworks?*
  • Does your dog demonstrate any inappropriate sexual behavior?*
  • Is your dog protective of any part(s) of their body?*
  • Does your dog ever demonstrate any of the following behaviors?*

  • Perspective & Expectations

  • Using the scale below, how would you rank your dog's overall behavior? 1 meaning the dog needs to be out of the house ASAP and 10 meaning they are perfect and nothing needs changing.*
  • Should be Empty: