Training Behavior Questionnaire

Dog Training - Behaviour Questionnaire

I appreciate this may seem a lot, but a detailed and comprehensive history, ensures that we start off the training on the front foot, and ultimately reach our goal quicker.
OWNER INFORMATION
Name

First NameLast Name
Address

Street Address

Street Address Line 2

Town / CityCounty

Post Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
DOG INFORMATION

If you are inquiring about more than one dog please complete an additional form.
Name
What is the breed and age of dog?
What is the sex of dog and neuter status?
Reason for contacting us
New puppy, new dog, new rescue, general training, problem behavior, other, etc.
Behavioural concern
Background: When did you first notice the tendencies of this problem behaviour?
Has there been a recent change in the behaviour? (More frequent? More intense? Different circumstances?) How often does it occur?
Can you anticipate when it is likely to happen? (When, where, who is present, trigger, etc.)
Why do YOU think your dog is doing this? What have you done so far to address this problem? With what effect?
What would you consider an acceptable goal/outcome of a training program?
Please describe several recent incidents in as much detail as possible.
OTHER BEHAVIOUR PROBLEMS
Check all that apply and are a concern to you and give details.

AnxietyAggression - DogsAggression - PeopleAggression - Other animalsBarking, vocalising excessivelyChasing moving objects (bike, vehicle, etc.)Chasing people or dogsCounter SurfingDemanding, attention seekingDestructive (chewing, scratching, etc.)DiggingDoor dashingEscaping (Fence jumping, etc.)FearHouse soilingJumping upRunning offSeparation distressStealing food, objectsUnruly (Jumping, mouthing, etc.)Other: humping, eating non food objects, compulsive behaviour...
Please describe...
HEALTH AND VETERINARY INFORMATION
Veterinary Clinic
Past relevant medical or health conditions or important medical history (allergies, medication, injury, etc)? If yes, please describe...
Have you specifically asked your Veterinarian about any of your dog’s training and behaviour concerns? If yes, what was their advice?
Please describe your dog’s behaviour at the veterinary office?
BACKGROUND INFORMATION
What are your reasons for having a dog? Where did you get your dog from? Include name of organisation if known.
How old was your dog when you got him/her?
What do you know as fact about your dog’s background? What are some of your reasons for choosing this particular dog?
HOUSEHOLD
Do you live in

a housea Flatan apartmentother
Who lives in the household with you? Is anyone in your household afraid of, or dislike your dog? Is there any conflict in the home regarding your dog’s behaviour and training?
Are there any other animals in the household? What is your dogs relationship to them? ie: friendly, nervous aggressive.
DIET AND FEEDING
What do you feed your dog? Please be specific (Brand, variety, canned, dried, raw, homecooked, etc) and amounts and frequency.
How food motivated is your dog? 1 - 10 (finicky ... voracious)
Please describe your dog’s mealtime. (Where, when, how often, who feeds, special routine, etc.)
Please describe any treat routine your dog has. (Who, what kind of treat, etc.)
ROUTINES

Activities
What would your dog say that her/his favourite pastimes are?
Play: What types of play do you engage in with your dog? Please describe.
Exercise: What types of exercise does your dog regularly get?
Lead Walks: Please describe: How often? Where? How does your dog act on lead?
Walking equipment: Please describe: What kind of lead, collar or harness do you use now?
What have you tried in the past?
Off lead time: Does your dog get off lead time? Please describe: Why or why not? Give any details.
Muzzle: Does your dog use a muzzle for any reason?
ROUTINES

Home Alone
How long is your dog left alone on an average day?
Where is your dog kept when you are not home?
What does your dog do when left home alone? Fine? Okay? Anxious/distressed?
What is your dog’s behaviour like when you leave home and return?
Is your dog content in a crate? If no, please describe history of exposure.
ROUTINES

Home Together
Day: What does your dog do when you are at home and not interacting with them?
Is your dog allowed on furniture?

YesNoWith permission
Do you have any special rules and boundaries in your home, yard, etc.?
Where does your dog rest in the day when you are home?
Night: Where does your dog sleep at night?
Are they a sound sleeper or easily disturbed? Settle easily? Please describe.
Meal time: What does your dog do when you have your meals/snacks?
ROUTINES

Visitors
How does your dog react when familiar people come to your home? Please describe: (Bark, jump, mouth, calm, etc.)
How does your dog react when unfamiliar people come to your home? Please describe: (Bark, jump, mouth, calm, etc.)
ROUTINES

Vehicle Outings ( If applicable)
Does your dog join you on car rides? Please describe: (How often? Where? How does your dog act? What type of vehicle? Where in the vehicle do they ride? etc.)
ROUTINES

Grooming and Handling
Which grooming tasks do you perform yourself? List: (Bathing, brushing, trimming, nail clipping, teeth cleaning, ear cleaning, none, other...)
How does your dog react? Please describe: (Calm, struggle, resist certain parts, bite, use a muzzle, etc.)
Does your dog go to a groomer?
ROUTINES

Toileting
Is your dog fully housetrained?
Does your dog urinate when excited/greeting/stressed, etc? Please describe.
ROUTINES

Other Activities
Please describe: Enrichment, games, jobs, etc.
TEMPERAMENT
What do you like about your dog? Name 2 or 3...
What do you find most annoying about your dog? Yes, you can mention that ;) Name 2 or 3...
TRAINING
What are some training goals that you would like to work towards?
How do you let your dog know when they have done something “good”?
What are some of your dog’s favourite rewards? Be specific.
How do you let your dog know when they have done something “bad”? How do they respond?
Has your dog participated in any professional training before? If yes, please describe. What type of methods were used? How was your experience and the results?
Have you ever used the services of a trainer with a past dog? If yes, with who? Please describe the experience: (Reason, training given, outcome, etc.)
SOCIABILITY

Interactions with Dogs and people
How would you describe your dog’s sociability with other dogs in general?

dog socialdog tolerantdog selectivedog defensivedog aggressive
Have they bitten a person or another dog and broken skin?
Are there situations that your dog tends to act aggressively towards people?

When people approach their food, dish, bone, etc?When people approach their possessions, toy, etc?When people approach their bed, couch, etc?When being handled, grabbed, restrained, etc?If disturbed while resting or sleeping?When visitors come to the home ?When out on a walk and sees people in the distance or passing by?When around familiar children?When around unfamiliar children?When around toddlers?When around babies?
If yes, please describe a typical episode (does dog growl, lunge or bite, and in what circumstance?):
Please describe typical episode (does dog growl, lunge or bite, and in what circumstance?):
Is there anything else that you would like us to know about your situation or your dog?
RATE FROM 1 – 6

1 - I would like to learn more but the problem is not serious
2 - I would like to change problem but it is not serious
3 - The problem is serious and I would like to change it, but if it remains unchanged that’s all right.
4 - The problem is very serious and I would like to change it, but if it remains unchanged I will keep my dog.
5 - The problem is very serious and I would like to change it; if it remains unchanged I will have my dog euthanized or give him/her up.
6 - I have almost given up already and am seriously considering having my dog euthanized or giving him/her up.
Please rate:
How much time per day total are you able to dedicate to training? (in 10-minute increments. ie: total 1 hour)
Please complete the form in as much detail as possible and from the perspective of everybody who interacts with the dog. EVERYBODIES opinions are valid and count. If there is more than one dog in the household please complete a seperate form.
Kind Regards

Mick
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Dog Training - Behaviour Questionnaire

OWNER INFORMATION

DOG INFORMATION

Behavioural concern

OTHER BEHAVIOUR PROBLEMS

HEALTH AND VETERINARY INFORMATION

BACKGROUND INFORMATION

HOUSEHOLD

DIET AND FEEDING

ROUTINES

ROUTINES

ROUTINES

ROUTINES

ROUTINES

ROUTINES

ROUTINES

ROUTINES

TEMPERAMENT

TRAINING

SOCIABILITY