Dog Behavior Questionnaire ABOUT YOU: Your name (required) Email (required) Address (required) Telephone (required) ABOUT YOUR DOG: Dog's name Breed or breed mix Sex MaleFemale Spayed / Neutered? YesNo Current age Age when you got him / her Where did you get your dog? BreederShelterRescue GroupFoundPrivate Adoption YOUR DOG'S BEHAVIOR: Has your dog ever bitten a person? YesNo How many times has your dog bitten a person, if applicable? What has been the resulting injury? (check all that apply) Left a red markCaused bruisingScratched the skinPunctured the skinRequired medical attention at a hospital or doctor's officeRequired stitchesRequired overnight hospitalization Briefly describe the three most recent incidents in which your dog bit a person Has your dog ever bitten another dog? YesNo Briefly describe the most three most recent incidents in which your dog bit another dog Describe any other behavior that you'd like to help your dog change YOUR DOG'S EVERYDAY LIFE: How many people live with your dog? Ages of children who live with your dog Do children under the age of 16 ever visit your home? YesNo List other animals who live in your home Does your dog regularly and successfully play with other dogs? YesNo How much time does your dog spend alone (without human beings) per day? with people all dayalone 1-3 hoursalone 3-6 hoursalone 6+ hours per day Where does your dog spend time when left alone? in fenced yardin yard with invisible / electric fencein crate indoorsin crate outdoorsin garagein certain parts of the househas free run of the house Does your dog use a doggie door for free access outside? YesNo What do you feed your dog? How do you feed? food is always available in a bowlbowl-fed at set feeding times What are your dog's favorite toys? Briefly describe a typical day in your dog's life. Include routines and daily exercise if any. HEALTH INFORMATION: Which veterinary clinic / hospital do you use? Which veterinarian do you usually see? List any medical conditions for which your dog is currently being treated. Do the medical conditions above (if any) cause frequent or chronic pain? YesNo List any medications your dog is currently taking other than heart worm or flea prevention. Were any of the above medications specifically prescribed for behavior issues? YesNo TRAINING HISTORY: Have you taken a group class with your dog? YesNo If Yes, where? Have you and your dog had private behavior coaching? YesNo If Yes, with whom? Has your dog been trained at a board-and-train facility? YesNo If Yes, where? How do you respond when your dog does something right? How do you respond when your dog does something wrong? Which training tools do you use, if any? FoodClickerProng CollarChoke CollarShock CollarHead Halter FINAL QUESTIONS: How did you hear about Michael's Dogs /Michael Baugh? How did you access this questionnaire? Web pageLink was sent to me via email
