Canine Behaviour Questionnaire

Country*:

Early History

Where did you acquire your dog from?:

Number of previous owners if applicable:

Please describe previous environments, i.e. family home, outdoor kennel, farm, children, other pets, hand-reared:

If from a rescue organisation, how long was he/she there:

What were the reasons for re-homing if known?:

Present Household

Please list other household pets:

Please include, breed, name, age, neutered and relationship with dog (avoids, plays, fights)

Please list human household members:

Please include name, age and Involvement (walks, feeds, grooms, play)

Who else is involved with the care of your dog? e.g. walkers, groomers, boarding facilities:

Please include name, involvement and frequency of attendance

Daily Routine

How long is your dog typically left alone on a weekday / weekend?:

Does he/she settle when left alone?:

Where in the household does he/she stay when left alone? :

Where does he/she sleep at night?:

Does he/she ever wake you at night?:

Does he/she have access to toys? Please add detail:

Is there access to a garden and at what times?:

Where does your dog tend to go to the toilet?:

Does he/she spot-mark with small amounts of urine?:

Does he/she tend to follow any particular person around the house?:

Please describe a typical 24 hr period for your dog:

Diet

What type and brand of food is your dog fed?:

What type or brand of treats are given, and how often?:

How many times a day is he/she fed, and at what times?:

Do you include supplements (please describe)?:

Where is your dog fed?:

Who feeds your dog?:

Does changing his/her food affect behaviour?:

Is your dog reactive in any way around food?:

Exercise

How often is your dog walked and for how long?:

What equipment is used (i.e. collar / body harness / lead / extending lead / head collar / muzzle)?:

Does your dog go off-lead on walks? If not, what are the reasons for this?:

Are games or toys incorporated into exercise? What types?:

Who initiates play - people or your dog?:

Does he/she interact with other dogs?:

How does your dog cope with car travel?:

Training

Have you and your dog attended training classes or seen other behaviourists?:

How old was he/she at the time?:

How long did you attend for?:

What overall training methods have been used, i.e. food rewards or lead corrections?:

What training equipment has been used?:

Do you recall training problems?:

Does your dog come when called:

Does your dog drop objects when asked:

Does your dog pull on the lead:

Does your dog walk to heel:

Behaviour Causing Concern

Please describe the behaviour causing concern. If more than one, please specify in the order of concern you place them in:

When does this behaviour occur?:

Is the behaviour directed at a particular individual?:

Who is usually present at the time?:

What happens immediately before these behaviours are displayed?:

Please describe how you or others react, or have reacted, to the behaviour:

When did this behaviour first occur? Please describe the first incident:

Are you aware of any change in circumstances or trauma for your dog around this time?:

Has the frequency or severity of this behaviour since increased?:

Please describe the last incidence:

Are you aware of related pets having behavioural or medical problems?:

Do other pets he/she has contact with display similar behaviours?:

Please describe previous methods used to resolve this issue:

What action would be considered if the behaviour continued?:

(Unneutered female dogs) Please indicate date of last season, if known:

(Unneutered female dogs) Does the behaviour alter around the season period?:

Does your dog ever display aggression? Please describe:

How does your dog react to visitors, children and strangers?:

How does your dog react to unfamiliar dogs?:

Please describe scenarios which cause your dog anxiety, i.e. vet visits, traffic, grooming, loud noises, being reprimanded:

Rehabilitation

Please describe your expectations of behaviour therapy:

Security Question:

I have read and agreed to the privacy notice:

Canine Behaviour Questionnaire

General Information

Clients details

Early History

Present Household

Daily Routine

Diet

Exercise

Training

Behaviour Causing Concern

Rehabilitation

Canine Behaviour Questionnaire

General Information

Clients details

Early History

Present Household

Daily Routine

Diet

Exercise

Training

Behaviour Causing Concern

Rehabilitation

Our Cookies

About Cookies

Cookie settings

Functional cookies

Analytics cookies

Marketing cookies