Behaviour assessment questionnaire

Behaviour questionnaire

Step 1 of 4

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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?

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?

Is your dog up to date on their worming and flea treatments?

Is your dog currently receiving any medication?

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

Neutered status

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.

Phone

This field is for validation purposes and should be left unchanged.