Behavior History Form

Behavior History Form
Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Dog's Info

NameBreedAge & GenderAltered?
Describe behavior for which you are seeking help: ex.) snapping at people, growling at dogs*
What is the highest level of a bite inflicted by the dog - Dr Dunbar's Bite Scale https://www.endlesspawsibilities.biz/_files/ugd/9a8686_ceb1a57cd22342749a4b7b9cd1979b5c.pdf *
When did you first notice this behavior? ex) after being attacked by a dog, after our vacation, after a move, 2 months ago*
Who is it directed at? *
Where does it happen / not happen? ex) in the home, on walks, at the park*
Why do you think it is happening?*
When does it happen? ex) when someone comes to the door, when someone approaches the dog, in the evening, when he's anxious*
Describe any intervention or training attempted?*
Any changes in the behavior?*
Is the dog on any medication or supplements? Please list.*
List any medical issues: current or former*
What food is your dog currently eating?*
Why did you choose this dog/ breed?*
Chose any/ all that apply to you/ your situation:*

This is a newer behavior and I want to get on it right awayI've tried multiple trainers or techniques without successI've tried other trainers, but want to learn even moreI'm at my wits end and this is my last attemptI'm hoping to learn as much as I can to help my dog as much as possibleI'm overwhelmed and just need something easy to implementI expect total elimination of my dog's bad behaviors. My dog must be perfect!I need to see change as quickly as possibleI'm open to any and all techniques and tools, so long as it will help my dogThere are certain tools or techniques I'm not willing to implementI have considered euthanasia due to my dog's dangerous behaviorI have considered rehoming my dogI'm excited to learn about holistic options for behavioral rehabilitationMy household is unpredictable and chaoticThis training has been court orderedMy dog has a police record
What is your expectation of training?*
Anything else you want to tell the behavior consultant?
Changing behavior requires time, consistency, commitment, and compliance. Do you have the time, effort, and desire to put in the work required to see a change in your dog?*
Should be Empty: