Canine Behavior and History Questionnaire Form
On or Off Leash Walks/Boarding
Owner Name:
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Owner Email:
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Owner Phone Number:
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What neighborhood in Asheville or surrounding area do you live in?
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How did you hear about us?
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Dog's Name:
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Dog's Age:
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Dog's Birthday
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Breed:
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Color/Markings:
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Dog's Sex
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What vaccines is your dog current on:
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Additional Vaccines? (Lepto, Lymes, Bordetella/Kennel Cough, Rattlesnake etc.)
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When was your dog last vaccinated:
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How long have you lived with your dog?
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Where did you get your dog?
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What do you know about your dog's history?
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Has your dog ever escaped from your yard?
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Is your dog potty trained to a yard? Does she or he need prompting or an escort in order to go?
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Does your dog use a crate?
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How much does your dog weigh?
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Under what circumstance is your dog most likely to bark at other people or dogs?
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How does your dog do in the car?
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Does your dog bark excessively at people or dogs from inside your car?
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Have you or do you currently train your dog using a collar that issues an electric shock? If so, please describe how you are using the collar and what behaviors you are trying to train.
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Has your dog ever growled at you? If yes, please explain:
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Has your dog ever bitten you, someone else or another dog? If yes, please explain:
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Can you take food, toys or stolen goodies away from your dog?
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Is there any situation or body area where you cannot touch your dog?
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Are there any people that your dog is uncomfortable around?
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Describe your dog's interaction with other dogs:
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How does your dog interact with small dogs - do you notice any over arousal or prey drive related behaviors?
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What kind of exercise does your dog get? How much and how often?
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Do you currently have a dog walker?
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Does your dog go off leash in parks and trails?
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How reliable is your dog's recall?
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Has your dog ever gone to doggie daycare? How did your dog like it?
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When walking on or off leash does your dog exhibit vocalizing, lunging or hyper distraction in response to environmental triggers? (presence of other dogs, skate boards, mail truck etc.)
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Is your dog comfortable walking on leash with other dogs?
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Is your dog allergic to anything?
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Is your dog on any medication? If so, please list:
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Does your dog have any injuries or physical concerns I should be aware of?
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Does your dog like to roll in anything? Or eat feces?
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What (if any) cues/commands does your dog know and respond to?
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Is there anything else you would like me to know?
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