Adopted Dog Behavior Evaluation

Adopted Dog Behavior Evaluation
Owner Information
Owner Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dog Information
Dog Name*
Dog Age*
Dog Gender*

Spayed FemaleNeutered Male
Dog Breed (or best guess)*
When did you adopt your dog?*
Why did you choose to adopt this particular dog?*
What are your three favorite things about your dog?*
Who is your veterinarian? *
Does your dog have any medical issues, including allergies? If so, please describe. *
If your dog is taking any medication, please list the drug and dosage.*
What brand of food do you feed? *
How many cups of food do you feed each day?*
What is your dog's feeding schedule? Check all that apply*

Food is available all/most of the time.Scheduled meals.My dog eats immediately and finishes their food.My dog is a picky eater and takes their time to eat/grazes.
What are your dog's favorite treats or snacks? *
What are your dog's favorite toys or games? (ex. fetching ball, frisbee, tug of war, etc.)*
Has your dog received any formal training? If so, please list the trainers/organizations you've worked with*
Do you have any previous training or behavior experience?*
Please check all the equipment you've used with your dog.*

Flat collarHarness - front or back clipHead halter - gentle leader etc.Choke chain/training collarPinch/prong collarBark collarElectric collarInvisible fenceCrateExercise penBaby gateTether (for time outside)Long line leashThundershirtOther calming products (aromatherapy, collars, herbs, etc)
Describe your dog's exercise routine (activity, distance/duration, frequency, locations, plus nap/down time and durations, etc.)*
Where does your dog sleep at night?*

In their crateIn my bedOn a dog bed in my roomOther
If other, please explain.
What is your typical schedule for work or school?*
Where is your dog when left alone?*
How often is your dog left alone?*
How does your dog do left alone?*
Does your dog show any of the following when left alone?*

shakingexcessive shakingpacingwhiningbarkinghowlingscratching at doors
Would your dog be comfortable and relaxed confined (behind a baby gate, or in a crate) if you were home in another room?*
Household Information
What is your neighborhood setting like?*

RuralSuburbanUrban
Do you have a fenced yard? If so, what type of fencing and approximate size?*
Are there dogs in the neighboring yards?*
If there are other people in your household, list them below (please include ages of children) *
Do you have frequent visitors to the home?*
How would you describe your household? Quiet and calm, bustling and noisy, or in between?*
Describe your dog's behavior and relationship(s) with human family members*
If you have other pets in your household, please describe them below (species, breed, age, gender, spayed/neutered, etc.)*
Describe your dog's behavior with other pets in the household.*
How does your dog react when strangers come to the door?*
How does your dog react after guests enter your home?*
What does your dog do if an unfamiliar dog comes into the house?*
What does your dog do when approached by an unfamiliar person on a walk?*
What would your dog do if someone unfamiliar tried to touch him?*
What does your dog do when approached by an unfamiliar dog on a walk?*
What does your dog do if a person or dog passes by the windows at the front of the house?*
What does your dog do if a person or dog walked by the parked car he was in?*
What does your dog do if you approach his food bowl while he is eating?*
What does your dog do if you approach him when he has a beloved toy, bully stick, or raw bone?*
What does your dog do if you try to take food, bones, or toys away from him?*
What does your dog do when bathed or brushed, has his toenails cut, or gets toweled off?*
What does your dog do when handled by the vet?*
What does your dog do in response to a sudden loud sound?*
Is your dog bothered by thunderstorms, gunshots, fireworks, or any other sounds?*
Does your dog tend to follow family member(s) around?*
Does your dog nudge, nuzzle, or paw for attention?*
What does your dog do if another dog approaches when you are giving attention?*
Given the opportunity would your dog chase a cat and/or wildlife?*
How does your dog behave around unfamiliar objects?*
On a scale of 1-5, 1 being calmest, how excited does your dog get when family members come home:*

1

2

3

4

5

1 is Calm, 5 is Excited
On a scale of 1-5, 1 being calmest, how excited does your dog get when playing:*

1

2

3

4

5

1 is Calm, 5 is Excited
On a scale of 1-5, 1 being calmest, how excited does your dog get when doorbell rings:*

1

2

3

4

5

1 is Calm, 5 is Excited
On a scale of 1-5, 1 being calmest, how excited does your dog get when just before a walk or ride in the car:*

1

2

3

4

5

1 is Calm, 5 is Excited
On a scale of 1-5, 1 being calmest, how excited does your dog get when visitors arrive:*

1

2

3

4

5

1 is Calm, 5 is Excited
Are there any other typical situations in which your dog will bark/lunge/growl/overreact that were not mentioned above?*
Does your dog:*

chase shadows or reflectionschase his talelick or chew excessively
Behavior Concern
Describe your dog's concerning behavior. Please be as detailed as possible (where it happens, how often, specific details, etc.) *
When did this behavior start?*
Were there any environmental or lifestyle changes that occurred around the time your dog's behavior changed? If so, please describe. (ex. moved, had baby, different roommates, job schedule change, etc.) *
What do you do when your dog exhibits this behavior? *
How does your dog react to your response?*
What changes (if any) have you made due to your dog's behavior?*
Have you consulted anyone else about this behavior? If so, what was the result?*
Has your dog ever bitten or injured a person? If so, provide details including circumstances leading to the incident, nature of injury, and level of medical attention needed. *
Has your dog ever bitten or injured another animal? If so, provide details including circumstances leading to the incident, nature of injury, and level of medical attention needed.*
Are you considering re-homing your dog or surrendering it back to the Animal Adoption Center?*
What times/days of the week would work best for you to meet with the training/behavior team? *
Should be Empty:

Adopted Dog Behavior Evaluation

Owner Information

Dog Information

Household Information

Behavior Concern