Canine Behavior Questionnaire
Your answers to these questions about your dog's behavior will help me better understand your concerns. If multiple dogs are involved, please include relevant information about them also.
Email address *
Owner's Name *
Your answer
Owner's Address (Street, City, State,Zip) *
Your answer
Phone (mobile) *
Your answer
Receive text messages? *
Phone (home)
Your answer
Do you agree to receive email notifications about your dog? *
What is your dog's name? *
Your answer
Your dog's breed and age? *
Your answer
Your dog's sex? *
Is your dog spayed/neutered?
Please describe any formal training that your dog has had. How long? Result? *
Your answer
What are your dog's most valued reinforcers (rewards)? *
Your answer
Describe your dog's problem behavior. *
Your answer
When does the behavior happen? *
Your answer
Where does the behavior happen? *
Your answer
Is the behavior always a problem or are there any times when it is OK? *
Your answer
What happens just before the behavior? *
Your answer
Can you do something to cause the behavior to happen? *
Your answer
Describe what happens immediately after the dog engages in the problem behavior. *
Your answer
How do you (or others) react? Do you pet, scold or ignore the dog? *
Your answer
What do other people present do when the problem behavior occurs?
Your answer
Does the presence of other dogs affect the problem? If so, describe what happens. *
Your answer
How does the dog benefit? What's in it for him? *
Your answer
Is there anything else I should know about your dog's behavior? *
Your answer
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