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About Your Vet
Name of Veterinary Practice
*
Email
*
Phone Number
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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About Your Pet(s)
Pet(s) Name
*
Breed
*
'Unknown' or 'Labrador cross Poodle'
Age of Pet
*
This can be an age range if unknown
When did you obtain your pet
*
Why did you want a pet in the first place? And, has this changed since having them?
*
Describe your pet(s) previous home(s) (if applicable/known)
*
Describe the behaviour of your pet's parents or littermates (if applicable/known)
Briefly describe your dog’s personality
*
E.g., quiet, confident, excitable, unruly, bold, stubborn
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Household Details
Who else lives with you and your pet(s)? Please list all the household members, ages and any regular visitors:
*
What is your experience (and the rest of the household’s) owning pets/this breed?
*
Please describe your household layout and any local things which impact how busy it is outside of the house
E.g., open plan home/large windows/garden/next to a busy school
Please feel free to upload any photos or videos of the house which might help me understand its layout and the presenting issues
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If you have a garden how long is the dog allowed access to this during the day?
Are there any areas the dog is restricted to/from? Why?
*
E.g. beds/sofas/upstairs
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Routine
This section looks at your lifestyle and your Pet(s)
Please give a brief rundown of the daily routine your dog has
*
E.g., walks/food time/wake/sleep schedule
Please give a brief rundown of your routine(s)
*
E.g., time at home/work, wake/sleep schedule
What does the dog eat (brand/type of food) for meals and if they have treats when do they have these and what kind of treats do you give?
*
Where are they fed and who by?
*
Where does your dog sleep at night & in the day?
*
Do you think your dog sleeps enough?
*
Dogs should sleep about 12-14 hours a day
How long do you tend to walk your dog every day?
*
Does your dog play with other dogs when on walks?
*
Where do you walk your dog and are they on/off lead (if off lead, for how long)?
*
Do you play any games with your dog, if so, what?
*
How often do you play, and for how long on average?
Do they have a favourite toy/game?
*
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Training
What do you do if your dog is doing something it should not be?
*
How do you reward your dog for good behaviour?
*
How would you describe what kind of training methods you use, if any?
*
Name your dog’s five favourite things
*
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Your Pet(s) Health
Have they been Neutered?
*
Please Select
Yes
No
Why were they neutered and did their behaviour change as a result of this?
*
Has your pet(s) ever had any medical issues? If so, briefly describe the issue and how it impacted them?
*
Type a question
Are they on any medication/herbal remedies or physical treatments now? If so, why?
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The Behavioural Issue
Please give as much detail as possible during the subsequent sections
Please describe the main issue you are looking to improve
*
When did it begin and how long has it been going on for?
When/where it happens? Does something trigger it?
Explain the context when it happens
Why do you think it began in the first place?
How has the issue developed over time?
Did it improve or get worse at any point? If so, do you know why?
Has homelife changed since the problem behaviour began?
*
E.g., house move, kids leaving for university, work patterns.
Have you tried anything already to try to help this behaviour?
*
How do you feel about this/these problem behaviour(s)?
*
Do you have any needs/wants about the current behaviour(s)?
Does this issue impact others around you and if so, how do they feel about it?
*
Does it impact relationships or stop you doing anything
What are your main short-term priorities/goals to work on?
*
What are your long-term goals to work on?
*
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Support
What does your support system around you look like? Who or what do you have around you to help?
*
This could be friends/family or paid services like pet sitters/walkers
Do you have anyone other than yourself who will be able to help with training going forwards?
*
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Expectations
What do you want out of this consultation?
*
What action would be considered if the behaviour continued?
*
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If you have anything else to add which has not been asked about in this questionnaire, please feel free to add it below:
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