Canine Behavior Questionnaire Template (Page 2 of 2) in pdf

Canine Behavior Questionnaire Template Page 2

BEHAVIOR PROBLEM INFORMATION:

Please describe your dog’s behavior problem:

How often does this problem occur? _______________________________________________________

Does it occur when the dog is left alone? ______ when the family is sleeping? _____ in the presence of a

family member? _______

What has been done so far to correct this problem? (discipline, confinement, obedience training, etc)

What was your dog’s response to the correction?

Please describe all situations which are likely to elicit aggressive behavior such as growling, nipping,

biting, attacking, etc. (ie: petting, approached by adults, approached by children, only when in the car,

reaching for, punishing, taking food or toys away, disturbed while sleeping, etc)

Please indicate any other behavior problems:

house soils

shy

pulls hard on leash

destructive chewing

jumps on people

pacing

aggressive

excessive grooming

barking

fighting

digging

runs away

destructive scratching

bites when verbally scolded

swallows non-food items

tail chasing

Please discuss any other information you feel is relevant to your dog’s problem:

Canine Behavior Questionnaire Template Page 2