Dog Behavior Consultation Questionnaire
Please also submit a Consultation Request so we can schedule the appropriate appointment.
Owner Information:
Owner Name:
Phone:
Format: (000) 000-0000.
Email:
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Dog Information:
Dog's Name:
Breed (or mix):
Age:
Sex / Spayed-Neutered:
Unaltered Male
Unaltered Female
Neutered Male
Spayed Female
How long have you had this dog?
Where did you get the dog?
Reason for Consultation
1. What specific behavior(s) are you seeking help for?
2. When did this behavior first start?
3. Has it gotten better, worse, or stayed the same?
4. What have you already tried to fix it?
Daily Life & Environment
5. Where does the dog live? (house, apartment, farm, etc.)
6. Who lives in the home? (adults, kids with ages, other pets)
7. How much exercise does your dog get daily?
8. How much mental enrichment does your dog get daily? (training, puzzles, sniffing, etc.)
9. Where does your dog sleep?
10. Is your dog crated? If yes, how do they behave in the crate?
11. How many hours is your dog alone per day?
Behavior History
12. Has your dog ever:
Snapped at a person?
Bit a person?
Snapped at another dog?
Bit another dog?
If yes, did the bite break skin on the person or animal?
Yes
No
Describe exactly what happened,
13. Has your dog ever growled, stiffened, or shown teeth at:
Adults
Children
Strangers
Dogs
Cats
During handling (grooming, vet, touching paws, etc.)
Triggers (check all that apply)
My dog reacts negatively to:
Strangers entering the home
People approaching on walks
Dogs on walks
Visitors
Kids running / loud noises
Being touched while resting
Food / toys / bones
Being moved off furniture
Nail trims / grooming
Vet Visits
Being restrained
Car rides
Doorways / thresholds
Being left alone
Sudden noises
Nothing specific - "out of nowhere"
Reactivity Details
14. What does the reaction look like? (barking, lunging, growling, freezing, snapping, biting, etc.)
15. How long does it take your dog to calm down afterward?
16. Can you interrupt the behavior once it starts?
Yes
No
Sometimes
17. Does it happen every time or only sometimes?
Social History
18. Has your dog lived with other dogs?
Yes
No
19. Has your dog lived with cats?
Yes
No
20. Has your dog been around children?
Yes
No
21. How does your dog do with strangers outside the home?
22. Has your dog attended daycare, dog parks, or group classes?
Daycare
Dog Parks
Group Classes
Other
Training & Handling
23. What cues does your dog reliably know?
24. What training methods have you used? (treats, prong, e-collar, verbal correction, etc.)
Medical
25. Any known medical issues?
26. Any recent vet visits?
27. Any pain, limping, licking, scratching, or sensitivity?
28. Is your dog on any medications or special diet?
Arousal & Stress Signals
29. Does your dog:
Pace
Whine
Pant when not hot
Follow you constantly
Startle easily
Have trouble settling
Sleep lightly
Overreact to sounds
Goals & Expectations
30. What would a "successful outcome" look like to you?
31. Are you willing to:
Use management tools (gates, leashes, crates)?
Change routines?
Practice daily exercises?
Avoid certain situations for now?
Additional Notes:
32. Is there anything else you think is important for me to know?
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