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 *
Owner's Name *
Owner's Address (Street, City, State,Zip) *
Phone (mobile) *
Receive text messages? *
Phone (home)
Do you agree to receive email notifications from me about your dog training? *
Would you also like to be included in future email articles from me about dog-related topics? You can unsubscribe at any time. *
What is your dog's name? *
Your dog's breed and age? *
Your dog's sex? *
Is your dog spayed/neutered?
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Please describe any formal or informal training that your dog has had. How long? Result? *
What are your dog's most valued reinforcers (rewards)? *
Describe your dog's problem behavior. Include as much detail as you can - even if you think something is unimportant. *
When does the behavior happen? Time of day? Before or after something else occurs? *
Where does the behavior happen? Only in certain places or in lots of different locations? *
Is the behavior always a problem when it occurs or are there any times when it is OK? *
What happens just before the behavior? *
Can you do something to cause the behavior to happen? *
Describe what happens immediately after the dog engages in the problem behavior. *
How do you (or others) react? Do you pet, comfort, scold or ignore the dog? *
What do other people present do when the problem behavior occurs?
Does the presence of other dogs affect the problem? If so, describe what happens. *
How does the dog benefit from the problem behavior? What's in it for him? In what way are the consequences of his actions rewarding? *
Does your dog have any relevant medical history or current medical issues that could impact his behavior? *
Is there anything else you want me to know about your dog's behavior or history? *
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