Behavior History Form
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Dog's Info
Name
Breed
Age & Gender
Altered?
Describe behavior for which you are seeking help: ex.) snapping at people, growling at dogs
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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
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When did you first notice this behavior? ex) after being attacked by a dog, after our vacation, after a move, 2 months ago
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Who is it directed at?
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Where does it happen / not happen? ex) in the home, on walks, at the park
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Why do you think it is happening?
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When does it happen? ex) when someone comes to the door, when someone approaches the dog, in the evening, when he's anxious
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Describe any intervention or training attempted?
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Any changes in the behavior?
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Is the dog on any medication or supplements? Please list.
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List any medical issues: current or former
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What food is your dog currently eating?
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Why did you choose this dog/ breed?
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Chose any/ all that apply to you/ your situation:
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This is a newer behavior and I want to get on it right away
I've tried multiple trainers or techniques without success
I've tried other trainers, but want to learn even more
I'm at my wits end and this is my last attempt
I'm hoping to learn as much as I can to help my dog as much as possible
I'm overwhelmed and just need something easy to implement
I expect total elimination of my dog's bad behaviors. My dog must be perfect!
I need to see change as quickly as possible
I'm open to any and all techniques and tools, so long as it will help my dog
There are certain tools or techniques I'm not willing to implement
I have considered euthanasia due to my dog's dangerous behavior
I have considered rehoming my dog
I'm excited to learn about holistic options for behavioral rehabilitation
My household is unpredictable and chaotic
This training has been court ordered
My dog has a police record
What is your expectation of training?
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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?
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Submit
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