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About
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Behaviour
Classes
Contact
Menu
Home
About
Training
Behaviour
Classes
Contact
Behaviour assessment questionnaire
Behaviour questionnaire
Step
1
of
4
25%
About you
Your name
First
Last
Your full address
Email
(Required)
Who lives with your dog (people and other pets)?
About your vet
Name and address of your dog's veterinary practice
Have you been referred to me by your vet?
- please select -
Yes
No
Are you planning to claim the cost of your behavioural consultation from your pet insurance? If so, please give the name of your insurer.
When did you dog last have a full vet check up?
When was the last time your dog visited the vets and what was that for?
Is your dog up to date with vaccinations?
- please select -
Yes
No
Is your dog up to date on their worming and flea treatments?
- please select -
Yes
No
Is your dog currently receiving any medication?
- please select -
Yes
No
Does your dog currently have, or has ever had, any medical conditions? Please give details.
About your dog
Your dogs name
(Required)
Date of birth / age (for rescue dogs please give estimated age)
Breed (if unknown please give your best guess)
Sex
- please select -
Female
Male
Neutered status
- please select -
Neutered
Unneutered
How long have you had your dog?
Where did you get your dog from?
About your dog's behaviour
Please describe the main issue that you are having with your dog that caused you to contact a behaviourist.
(Required)
When did your dog start showing this behaviour?
(Required)
Please describe any other behavioural issues that you are having with your dog.
Has your dog ever bitten (even very mildly) another dog? Please describe any times this has happened.
Has your dog ever bitten (even very mildly) a human? Please describe any times this has happened.
Please describe what your dog does if a person comes to your house.
What training has your dog had in the past?
Please provide any further information that you think it would be useful for me to know here.
Consent
I have read and agree to the
training and behaviour waiver
.
Privacy
I have read and agree to the
privacy policy
.
Comments
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