Thank you in advance for taking the time to complete this questionnaire.
The aim of the questionnaire is to gather as much information as possible for the behaviour concern you are experiencing with your dog. I understand that you might not know the full answers to the questions but please answer the questions as fully as you can for the time you have known your dog. You may also find that not every part of the questionnaire will be relevant to your dog's problem, so please do not worry about leaving those sections blank
Are any of these members under 12yrs old? Yes - Please let us know their name and age:
Do you have any other pets? Yes - Please let us know their name, species, and age:
The current problem behaviour(s): Please describe in a few words the behaviour(s) you want to discuss during the consultation in order of priority:
Have you tried anything to help with your dog's behaviour? If so what?
Has your dog ever shown any behaviours such as growling, snarling, showing teeth, nipping, lunging, snapping, biting?
Yes - Please continue to the next question
No - Please continue to Your Dogs Personality
What are your dog's favourite treats?
What are your dog's favourite activities or toys?
Do you walk your dog? Yes - Please continue to the next question
No - Please continue to General health
If yes, please let us know the name
I confirm the following :
Information that I provide about me, my household, and my pets to be correct to the best of knowledge. Any information not disclosed or found to be inaccuaate could lead to a misdiagnosis of the required treatment or approach.
Please ensure the relevant investment fee is paid in full using the following details:
Lloyds Bank Account : 39816368
Sort Code : 30-84-20
Please return the completed form either by email: email@example.com or by post to: Jenny Baxter, 22 Easton Square, Sherston, Malmesbury, SN16 OLX
Once the questionnaire, veterinary referral/medical history and payment are all received I will contact you to confirm receipt. At that point return to positivelydogs and select a convenient time and date for both the initial call and consultation visit.