K9 Advantage Behavior Questionnaire

Behavior & Evaluation Questionnaire
Your Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail*
Family members

HusbandWifeChild 0-2Child 2-5Child 5-8Child 8-12Child 12- 16Child 16 & olderOther
How did you find K9 Advantage

OnlineWord of mouthRadioOther
Dog
Please complete the questions below as accurately as possible.
Dog's Name*
Sex*

MaleFemale
Breed*
Date of birth*
Physical and Medical
Vet's Name
If You have your own www.com
Vets's Phone

Area CodePhone Number
When was last vaccination & exam?
Has this dog been neutered/spayed?

YesNo
How old, in months, was the dog when neutered/spayed?
What was the reason for neutering/spaying?
Any behavioral changes after neutering/spaying?
Has this dog been bred?

YesNo
If you have not yet bred this dog, do you plan on breeding him or her?

YesNo
Any behavioral changes after breeding? If Yes please explain.
List any medical problems, allergies, & medications
Background
How long have you had this dog, in months?
If you adopted your dog, tell me about any background you have on your dog.
Where did you get your dog?

Stray/foundBreeder-backyard breederShelterBreed rescue serviceFriendBreeder-serious show/performance breederOther
Why did you choose this particular dog?
How do you feed your dog?

Free feed (keep food in the bowl all the time)Set times (only enough for each feeding)
What food (brand names) is your dog fed?
What treats does your dog get (brand names, amounts, and schedules)
Does your dog get anything else to eat?

NoOther
How is your dog exercised/maintained?
How many walks does your dog get daily, and how long are these walks?
How many play sessions does your dog get daily?
How many training sessions does your dog get daily?
How is your dog kept when you leave him or her alone?

free in housefree outdoorsindoor kennel/runoutdoor kennel/runcrate indoorscrate outdoors or garagebehind a gate or door in houseOther
How long does your dog spend alone?
in hours
What percentage of time is your dog inside?
example - 20%
Where does your dog sleep?
How does your dog behave in the vehicle?

CalmExcitedNervousPacesBarks at loud fast moving vehiclesGets sick
Training
What type of training are you interested in?

Private SessionsComplete Obedience PackageBoard & TrainClasses
Describe your training goals for your dog.
Who is responsible for training your dog?
What is your dog's obedience school/training history?

No school-trained yourselfPuppy kindergardenGroup lessons-basicGroup lessons-advancedPrivate trainer at housePrivate trainer-sent to trainerAgilityFlyball
Age when dog started lessons/training in months:
How did the dog do in obedience school/training?
Please list all the animals (include all pets, even non-dogs) in the household.
Describe how you reward your dog for good behavior.
Describe what you do with your dog for unwanted behavior, and give an example of the circumstances under which you might do so.
Do you use a crate?

YesNo
What is your dog's favorite toy?
What is your dog's favorite activity?
Behavior Issues
What behaviors would you like to change? check all hat apply

Jumping on peopleChasingRunning awayStealingGets on furnitureExcessive chewingNippingDoes not listenDiggingOut of control barkingCounter surfingCrate training problemsPlaying roughProblems housetrainingNot coming when calledPulling on walksBegging at tableAggressive towards peopleAggressive towards dogs
Has the frequency of the behavior?

IncreasedDecreasedRemained the same
Has the intensity of the behavior(s)

IncreasedDecreasedRemained the same
Under what specific circumstances does the behavior(s) occur?
Handling Issues
Activities you or family member cannot do

Pat top of headReach for dogLean over dogStep on dogPick up dogPush off couch or bedBathe dogBrush dogPull fur including tailCheck teethCheck/clean earsClip nailsGrab or pull on collarAttach leash to collarHugRestrainNo problem
At vet or groomer

Growls no biteLungesNo growl, will biteBite has broken skinHas to be muzzledOver excitedNot a problem
My dog is less accepting of touch on

FeetFaceEarsTailMouthTop of head
My dog's reaction is

Pulls awayGrowlsSnarlsMouthsWarning nipsSerious bite
Resource Guarding Issues
What items does your dog guard?

Food bowlToysTreatsBones/RawhidesAll possessionsMe or family memberNot a problem
My dog's reaction is

Runs away with itemGrowlsShows teethWarning nipsSerious bite
This behavior is more intense

Feeding areaOn couchIn crateUnder tableBack yardOther
This behavior started when

In the last couple weeks1 to 6 months ago6 months to a yearOver a year
When your dog has a valued item, what is his reaction if someone approaches?

Stiffening of bodyFreezesStaresGrowlsAir snappingLungesSerious biteRuns awayWill drop/give eventuallyNot a problem
How long has your dog been guarding?

Since a puppy6 months or olderJust started recently
What have you done to address this issue so far? Please be specific.
Reaction to People
What is your dog's reaction to strangers?

Over excitedBarksHair raises on backGrowlsSnarlsLunges at personStares at personBacks upAir snappingHides behind youRuns away & hidesNot a problem
My dog has this reaction when

Someone comes in yard/houseMeeting on walksDoorbell or knock on doorPeople walking past yard/houseOnly when person enters housePerson goes to petPerson turns & walks awayOther
This behavior has become

More frequentMore intenseStayed the same
My dog does not like

KidsTeenagersMenWomenElderlyHatsSunglassesPurses/PackagesFacial hairBeing pettedLoud noisesThunderGesturingFast movementsComing toward himFamily member
In detail, what has been done to address the issue so far? Describe results.
If your dog has bit someone Describe in detail circumstance of bite. Who, when, where, how, seriousness of bite.
Reaction to Other Dogs
What is your dog's reaction to another dog?

Over excitedBarksHair raises on backGrowlsShows teethLunges at dogStares at dogBacks upStiffening of bodyHides behind youRuns away & hidesNot a problem
My dog has this reaction when

Other dog comes in yard/houseMeeting other dog on walksAt the dog parkOther dog walking past yard/houseOnly with certain dogsOther dog turns & walks awayOn leashOff leash
This behavior has become

More frequentMore intenseStayed the same
This behavior started when

Young puppy6 months to a yearAdultJust started recently
In detail, what has been done to address the issue so far? Describe results.
If your dog has attacked another dog, please describe in detail the circumstances of the fight.
Should be Empty:

Behavior & Evaluation Questionnaire