• Canine Behavior Appointment Request & Questionnaire

  • Behavior Program Information

    Thank you for your interest in our Behavioral Services at Mount Laurel Animal Hospital! We wanted to provide you with information regarding our Behavior Program.
      

    An initial Behavioral consultation includes the following:  

    • Initial examination and consultation with our board-certified Veterinary Behaviorist, Dr. Shana Gilbert-Gregory 

    • 1 complimentary Treatment Appointment with our Behavior Modification Technician

    During the initial appointment, you can expect that our Behaviorist will do a comprehensive review of your pet's history and a physical exam (as long as it is safe to do so). She will make recommendations to address your pet's symptoms that may include medication therapy, identification and modification of possible environmental triggers, behavior modification plans, etc. We will never do anything to provoke or frighten your pet as it is not necessary for us to observe their behaviors in order to be able to understand the problem. The goal of a Behavioral Consultation is to create an individualized treatment plan that works for you and your family to help your pet to be able to live successfully in their family and in the community. 

    The cost of a Behavioral Consultation is $550. Due to the nature of Behavioral Medicine, we do not always have the ability to take payment during the time of the consultation. As such, we require payment for the consult at the time of scheduling. The full amount will be refunded if cancelled or rescheduled with at least 48 hours notice. 

    Follow Up Care: Your behavior appointment includes 1 (courtesy) behavior modification treatment appointment within 2 months of your initial appointment and follow up with the behavioral medicine service (via phone and/or email) for the first five weeks following your initial visit. If any significant changes to the treatment plan need to be made, including medication changes, a recheck appointment may be required.

    Behavior medications may be prescribed for up to 6 months following your appointment at the discretion of the Behaviorist. After that, your pet is required to see the doctor every 6 months for a re-check. These appointments will have an additional fee. You have the option of having your regular veterinarian take over your pet’s prescription(s) if it is safe to do so.

    Our Behavior Service is typically booked out 5-6 months for new consultations. Due to this, we keep a Waitlist in the event that someone cancels, so you may be able to be seen sooner. We truly apologize for this inconvenience. While we want to help as many pets and families as possible, we understand that your pet may require care sooner. In the event that you must seek care elsewhere, please know that you can find other board-certified Veterinary Behaviorists near you using the American College of Veterinary Behaviorists website: https://www.dacvb.org/. All requests are triaged within 24 hours, and emergencies may be scheduled sooner at the discretion of our Behavioral Department.

    Please be advised a questionnaire must be filled out for each pet being seen prior to scheduling an initial consultation with our Veterinary Behaviorist.

    The information you provide to us in this form is integral to understanding your pet's history and lifestyle as well as your goals with our program.

    A member of our scheduling team will reach out to you within 7 buisness days to confirm receipt of the questionnaire. Please keep an eye on your SPAM folder as our emails may end up there. 

    All requests are triaged within 72 hours, and true behavioral emergencies may be scheduled sooner at the discretion of our Behavioral Department. 

  • Client Contact Information

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  • Would you like to add another contact to your account?*
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  • Have you been to Mount Laurel Animal Hospital previously?*

  • Your Pet's Information

  • Has your pet ever visited Mount Laurel Animal Hospital?*
  • Is this Estimated or Known
  • Preferred Day Of Week

  • Primary Vet Information 

    Please have your pet's veterinary records emailed to Appointments@mlahvet.com or fax Attn: Behavioral Medicine to (856) 231-8393. 

  • Format: (000) 000-0000.

  • Referral Information

  • HOME ENVIRONMENT

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  • Behavior History

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  • Has the frequency or the intensity of the occurrence of the behavior changed since the problem started?*

  • BACKGROUND INFORMATION

  • Has your dog had other owners?*
  • Did you meet your dog's parents or do you have any information about littermates?*
  • Was a temperament test performed before or when you acquired your dog?*

  • INTERACTIONS & RESPONSES

  • Interactions With Other Animals

  • Interactions With Household Members

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  • Interactions With Non-Household Members

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  • What Is Your Dog's Response to Visitors?

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  • Response to Attempted Corrections

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  • ENVIRONMENT

  • Do you have a yard?*
  • Has your house changed at all since you acquired your dog?*

  • DAILY SCHEDULE

  • Does someone go out with the dog when in the yard?
  • Does your dog have access to outside through a dog door?*
  • Do you limit your dog's access to any part of the house when you are home?*
  • Do you put them there or do they choose to go there themselves?*
  • Do you play with your dog?*
  • Does your dog eliminate in the house?*
  • If yes, do they urinate, defecate or both?
  • Do they eliminate in the house when you are home, they are alone, or both?

  • DIET AND FEEDING

  • Does your dog typically finish each meal?*
  • Does someone have to be present for your dog to eat?*
  • Does your dog have any food allergies or diet restrictions?*
  • Is water available to your dog 24 hours a day?*

  • MEDICAL HISTORY

  • Is your dog spayed/neutered?*
  • Have they ever been bred?*
  • Is your dog currently receiving heartworm and flea/tick prevention?*
  • Do you ever use the following medications to treat your dog? Select all that apply.*
  • Is your pet currently on any medications, supplements, or vitamins?*
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  • Has your dog ever been on any behavioral medications or supplements in the past?*
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  • TRAINING

  • Have you ever attended a training class or had a trainer come to your home?*
  • Have you consulted with any other behavior specialists prior to your appointment with us?*
  • Which tasks will your dog reliably perform on verbal cue? Select all that apply.*
  • Did you have any difficulties house training your dog?*
  • Have you ever used a crate?*
  • If yes, do you still continue to use it?

  • MISCELLANEOUS

  • Does your dog ever mount people, dogs or objects?*
  • Does your dog ever lick himself, people or inanimate objects obsessively?*
  • Is your dog sensitive to having certain body parts touched or handled (especially ears and feet)?*
  • Has the frequency or intensity changed since the behavior started?*

  • BITE HISTORY

  • Has your dog ever bitten anyone?*
  • Has there been legal action taken against you as a result of any bites?
  • Have you read any dog training books?*
  • Have you considered finding another home for your dog?*
  • Have you considered euthanasia (putting your dog to sleep)?*
  • Has anyone recommended euthanasia before your visit here?*

  • EXPECTATIONS

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