Canine Behavior Solutions and Obedience
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Going to the Dogs
Help for your dog
Choosing a Dog
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Need more information?
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In person consultation
How did you acquire your dog?
At what age?
Who is your vet?
What is their phone number?
How long have you been with them? If you have changed vets please put former vet information under more information space.
Is your dog current on all vaccines including Rabies and Canine Influenza? if so please give dates of vaccination a copy of this will need to be given at or before consultation.
Have you had any recent blood work on your dog?
What does a typical day for your dog look like?
What food do you feed?
Do you give your dog any medications or supplements? If so please list them.
What kind of exercise schedule do you have with your dog?
Do you offer bones, toys to your dog if so what kind?
What behavior led you to seek help?
Aggression towards unfamiliar dogs
Agression towards family members
Aggression towards visitors
Aggression when picked up/handled
Barking at other dogs/people
Aggression towards another pet in the home
Unable to leave alone/destroys items when alone
Barks at noises/ scared of thunder/fireworks
Aggression towards people in public
Aggression towards vet
Aggression towards vet/dog walker/groomer
Unreasonable fear of item/people
Pulling on leash
Running out door
Pick the issue your dog has that has caused you concern.
When did this behavior start? (approximate date or how long)
Other behavior not listed
Has any of the following occurred recently that could impact the change of your dogs behavior?
Person moving out of the home
Recent vaccination/medical procedure
Environmental change (construction, etc.)
New person/baby in home
New pet in home
Pet in home Lost/dying/injured/rehomed
Moved to new location
Use of physical corrections
Sent away for training
Change in medication
Change in amount of exercise
Change in diet/treats
Less time to spend with dog
Attack by another dog/animal/person
None of above
Other item not listed/ describe in detail
What has been done to address the issue?
What result did this have?
Became a bit worse
Became much worse
Improved greatly but other behavior became worse
If your dog has issues with separation anxiety how bad is the behavior?
Cannot be out of sight of one person or they cry and follow.
Cannot be left alone at all, tears up items in home.
Cannot be out of sight of one person or screams/ drools excessively/defecates.
Can be left with other people easily.
Cannot be be left alone with other people at all destroys items/furniture/crates.
Destroys crates/walls/furniture when left alone completely
What have you tried to help solve this?
Did It help?
Yes completely resolved the issue.
Yes it kind of helped.
Yes but other issues became worse
No it made it worse.
No it is unchanged.
If your dog has bitten another dog or threatened to bite another dog please check all that apply.
Growls, lunges, and/or barks at other dogs on walks
Growls, lunges, barks at another dog in home
Bit another dog off leash (no blood)
Bit another dog off leash (drew blood)
Bit another dog inflicted multiple puncture wounds
Has air snapped at another dog (no contact)
Bit another dog on leash
Play fights escalate into fights
Bit another dog inflicted minor puncture wound
Tried to kill another dog ( shake, grab and run etc)
If your dog has bitten or threatened to bite a person please check all that apply.
Threatened no bite ( air snapped, growled, barked, lunged at family member )
Threatened no bite a stranger in public
Threatened no bite to visitor in home
Bit family member no broken skin
Bit family member, single puncture wound
Bit family member, broken skin/torn
Bit family member multiple wounds
Bit stranger in public no broken skin
Bit stranger in public single puncture wound
Bit stranger in public broken skin/torn
Bit stranger in public multiple wounds
Bit visitor no broken skin
Bit visitor single puncture
Bit visitor broken skin/tear
Bit visitor multiple puncture wounds
Bit vet or vet tech
Threatened no bite to vet or vet tech
Bit Dog walker/pet sitter
Threatened to bite dog walker/pet sitter
Any other not listed
Please give as many details about the incident that made you determine to seek help. If there are additional incidents please place in comment section marked additional information.
Date of incident
Location of incident
Who was present
What other dogs or animal were present
Was your dog on a leash?
If so who had the leash?
What preceded the incident?
Did your dog give any warning signs? ( Bark/growl/hackles up, etc) If so what were they?
had your dog been feeling well before the incident?
If there was bite location of the bite on body
Did it cause bruising?
Was there bleeding torn skin?
Were there multiple puncture wounds?
Was there a puncture wound?
Did the dog latch on and shake his head from side to side, not letting go?
How did the incident end? Pulled dogs apart, person walked away etc
What happened right after the incident? Put dog in yard, dog was hit etc
If there was a bite
Medical help was sought
Medical help was not sought
Bite was reported
Bite was not reported
Legal action was not taken
Legal action was taken
Additional information/ incidents
Which one describes how you feel about your dogs behavior?
I think the issue can easily be resolved but am interested to hear your thoughts.
I want to fix this, it is aggravating, but I can live with it.
This is not something I take lightly and am concerned greatly. I can mange the behavior if I must if it cannot be changed.
This is something that could result in me euthanizing or rehoming my dog. It has to change.
Other feelings about behavior
Anything else that you feel is relevant to your dogs behavior or needed services?
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