Behaviour Questionnaire

Your Name:*

Address:*

Home Phone Number:

Mobile Number:*

Email Address:*

Dog's Name:*

Sex:

Male
Female

Dog's Date of Birth:*

Breed:*

Is he/she Neutered?:

Yes
No

How Long have you had your dog?:*

How old was he/she when you got them?:*

Where was he/she from?:*

Please provide background information. EG: which rescue centre, circumstances surrounding rehome etc.:*

What do you feed your dog? Brand, wet, dry etc.:*

How often do you feed your dog?:

What treats/ titbits do you give your dog?:*

Does your dog Sit on command?:*

Does your dog Lay Down on command?:*

Does your dog Stay on command?:*

Does your dog drop objects on command?:*

Does your dog come back when you call?:*

Does your dog steal items around the house?:*

Does your dog steal food?:*

Does your dog jump up to greet people?:*

Does your dog jump on your lap without invitation?:*

Does your dog bark/paw/jump up/nuzzle for attention?:*

What might you discipline your dog for (E.g. Jumping up, barking at the cat, stealing a sock etc.):*

How do you discipline your dog?:*

Please give details of any previous training(Including the trainer/company, methods used, size of class, how long training lasted, what effect it had):*

Does your dog tend to follow you around the house?:*

Is your dog affectionate?:*

Describe the problem you are having in as much detail as possible:*

Has your dog ever caused physical injury?:*

If so, what? (e.g. drawn blood, bruising, puncture wounds)::

Who is your regular veterinary surgery?:*

Does your dog have any current or past medical problems to your knowledge?:*

If so, are they on any medication?:

Please list all animals in the household, the sequence they were obtained in and any behaviour problems they have.:*

Is your dog left alone regularly? If so, for how long?:*

Are there any problems when you leave him/her?:*

How does your dog behave when you leave the house, when you return, and what do you do?:*

How many hours of exercise does the dog get each day, who exercises them and is it on or off lead?:*

Have you booked an Assessment?:

Yes
No

I am happy for you to store and use the above information to provide me with an excellent service::

Yes

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Chanterlands Avenue, HU5 4EF