DOG INFORMATION

If you are inquiring about more than one dog please complete an additional form.

Dog's Name *

Dog's Information *

REASON FOR CONTACTING US - Please Describe *

PRESENTING PROBLEM #1

What is the main reason/problem that you are inquiring about? *

Background: When did you first notice tendencies of this problem behaviour? *

Has there been a recent change in the behaviour? (More frequent? More intense? Different circumstances?) *

How often does it occur? *

Can you anticipate when it is likely to happen? (When, where, who is present, trigger, etc.) *

Why do you think your dog is doing this? *

What have you done so far to address this problem? With what effect? *

What would you consider an acceptable goal/outcome of a training program? *

Please describe several recent incidents in as much detail as possible. *

PRESENTING PROBLEM #2

or skip to next section

What is the secondary reason/problem that you are inquiring about?

Secondary - Background: When did you first notice tendencies of this problem behaviour?

Secondary - Has there been a recent change in the behaviour? (More frequent? More intense? Different circumstances?)

Secondary - How often does it occur?

Secondary - Can you anticipate when it is likely to happen? (When, where, who is present, trigger, etc.)

Secondary - Why do you think your dog is doing this?

Secondary - What have you done so far to address this problem? With what effect?

Secondary - What would you consider an acceptable goal/outcome of a training program?

Secondary - Please describe several recent incidents in as much detail as possible.

HEALTH AND VETERINARY INFORMATION

Veterinary Clinic *

Is your dog up to date on vaccinations and protocols as recommended by your Veterinarian? *

If your dog is not up to date on vaccinations, please advise (ie: Titre, health, etc.)

Allergies? *

Medications? *

Past relevant medical or health conditions or important medical history (allergies, medication, injury, etc)? If yes, please describe...

Have you specifically asked your Veterinarian about any of your dog’s training and behaviour concerns? If yes, what was their advice?

Do we have your permission to contact your Veterinarian about your dog’s behaviour?

Please describe your dog’s behaviour at the veterinary office?

BACKGROUND INFORMATION

What are your reasons for having a dog? *

Where did you get your dog from? Include name of organization if known. *

How old was your dog when you got him/her? *

What do you know as fact about your dog’s background? *

What are some of your reasons for choosing this particular dog? *

HOUSEHOLD

Do you live in a : *

Do you have a yard? *

Is your yard fenced or unfenced?

Relevant changes or dynamics that may affect your dog: *

Is anyone in your family afraid of, or dislike your dog? *

Is there any conflict in the home regarding your dog’s behaviour and training? *

Environment around the home:

DIET AND FEEDING

What do you feed your dog? Please be specific (Brand, variety, canned, dried, raw, homecooked, etc.) *

How food motivated is your dog? 1 - 10 (finicky ... voracious) *

Does your dog guard their regular meal against humans? (growl, snap, etc.) *

Please describe any treat routine your dog has. (Who, what kind of treat, etc.) *

ROUTINES - ACTIVITIES

What would your dog say that her/his favourite pastimes are? *

Play: What types of play do you engage in with your dog? Please describe. *

Exercise: What types of exercise does your dog regularly get? *

Leash Walks: Please describe: How often? Where? How does your dog act on leash? *

Walking gear: Please describe: What kind of leash, collar or harness do you use now? *

What have you tried in the past? *

Off leash time: Does your dog get off leash time? Please describe: Why or why not? Give any details. *

Muzzle: Does your dog use a muzzle for any reason? *

ROUTINES - HOME ALONE

How long is your dog left alone on an average day? *

Where is your dog kept when you are not home? *

What does your dog do when left home alone? Fine? Okay? Anxious/distressed? *

What is your dog’s behaviour like when you leave home and return? *

Is your dog content in a crate? If no, please describe history of exposure.

ROUTINES -

HOME TOGETHER

Day: What does your dog do when you are at home and not interacting with them? *

Is your dog allowed on furniture? *

Do you have any special rules and boundaries in your home, yard, etc.? *

Where does your dog rest in the day when you are home? *

Night: Where does your dog sleep at night? *

Are they a sound sleeper or easily disturbed? Settle easily? Please describe. *

Meal time: What does your dog do when you have your meals/snacks? *

ROUTINES - VISITORS

How does your dog react when familiar people come to your home? Please describe: (Bark, jump, mouth, calm, etc.) *

How does your dog react when unfamiliar people come to your home? Please describe: (Bark, jump, mouth, calm, etc.) *

ROUTINES -

VEHICLE OUTINGS

Does your dog join you on car rides? Please describe: (How often? Where? How does your dog act? What type of vehicle? Where in the vehicle do they ride? etc.) *

ROUTINES - GROOMING AND HANDLING

Which grooming tasks do you perform yourself? List: (Bathing, brushing, trimming, nail clipping, teeth cleaning, ear cleaning, none, other... *

How does your dog react? Please describe: (Calm, struggle, resist certain parts, bite, use a muzzle, etc.) *

Does your dog go to a groomer? *

ROUTINES - ELIMINATION

Is your dog fully housetrained? If no, describe. *

Does your dog mark indoors? *

Does your dog urinate when excited/greeting/stressed, etc? Please describe. *

Any other details regarding elimination?

ROUTINES -

OTHER ACTIVITIES

Please describe: Enrichment, games, jobs, etc.

TEMPERAMENT

What do you like about your dog? Name 2 or 3... *

What do you find most annoying about your dog? Yes, you can mention that ;) Name 2 or 3... *

TRAINING

What are some training goals that you would like to work towards? *

What are some of your training successes? Tricks count ;) *

What are some of your training challenges? *

How do you let your dog know when they have done something “good”? *

What are some of your dog’s favourite rewards? Be specific. *

How do you let your dog know when they have done something “bad”? *

What types of corrections have you tried or currently use? (interrupt, redirect, time out, verbal reprimand, physical reprimand, scruff, muzzle grab, alpha roll, squirt bottle, throw chain, shake can, choke collar, pinch collar, citronella collar, electronic/stimulation/shock collar, etc.) *

With what effect? (ie: no change, stopped behaviour, got worse, only worked with certain person, etc.) *

Has your dog participated in any professional training before? If yes, please describe. *

What type of methods were used?

How was your experience and the results?

Have you ever used the services of a trainer with a past dog? If yes, with who? Please describe the experience: (Reason, training given, outcome, etc.) *

SOCIABILITY - INTERACTIONS WITH DOGS

How would you describe your dog’s sociability with other dogs in general? *

What is your dog’s typical play style: Chase? Bully? Wrestle? Body slam? Other? *

Does your dog attend doggie day care, dog walker or a boarding facility? *

Does your dog regularly attend “Dog Parks”? If yes, please describe: park type, dog interactions, your dog’s behaviour, etc. *

Has your dog ever shown any worrisome aggressive behaviour to other dogs (lunging, growling, baring teeth, snapping, nipping, biting, etc.)? *

If your dog has shown aggressive behavior towards other dogs, please describe

Have they bitten another dog and broken skin? *

What is the ratio of “fights” to bites? Ie: 20 fights and one bite.

Has your dog ever been BITTEN BY another dog? If yes, please describe.

SOCIABILITY

INTERACTIONS WITH OTHER ANIMALS

What is your dog’s experience with cats? *

Any negative experience with other domestic animals? (horse, chickens, etc.)

Has your dog had experiences with wildlife that worried you?

SOCIABILITY INTERACTIONS WITH PEOPLE

Has your dog ever shown any worrisome aggressive behaviour to any people (lunging, growling, baring teeth, snapping, nipping, biting, etc.)?

If your dog has shown aggressive behavior to people, please describe.

Have they bitten and bruised or broken skin?

In what situations does your dog tend to act aggressively towards people?

When people approach their food, dish, bone, etc.? If yes, please describe:

When people approach their possessions, toy, etc.? If yes, please describe:

When people approach their bed, couch, etc.? If yes, please describe:

When being handled, grabbed, restrained, etc.? If yes, please describe.

If disturbed while resting or sleeping? If yes, please describe:

When visitors come to the home and property? If yes, please describe:

When visitors move around inside the home? If yes, please describe.

When out on a walk and sees people in distance? If yes, please describe.

When out and about and people pass. Jogging, on bikes, skateboards, etc.? If yes, please describe:

When around familiar children? If yes, please describe:

When around unfamiliar children? If yes, please describe:

When around toddlers? If yes, please describe.

When around babies? If yes, please describe:

Please answer yes or no to these characteristics of your dog's aggressive behaviour.

Attacks are sudden and surprising

Episodes appear unprovoked

The dog is abruptly docile after an episode

The dog appears "sorry" afterwards

The dog appears disoriented afterwards

Episodes are associated with a "glazed" or "absent" expression

I can usually tell what will set off my dog

The aggressive behavior is new and uncharacteristic

Has your dog bitten and broken skin?

Number of bites that broke skin:

Total number of bites (that did or did not break skin):

Total number of episodes of aggression (growling, snapping, biting):

Please describe typical episode (does dog growl, lunge or bite, and in what circumstance?):

If the dog is in the above situation 10 times, in how many of those times is aggression seen (all=100%, just one=10%, etc.)?

What parts of the body has the dog bitten and how severe were the injuries?

Who is/are the target(s) of aggression?

Did your dog show worrisome behaviour as a puppy?

How old was your dog the first time he/she growled at a person?

Is there anything else that you would like us to know about your situation or your dog?

How much time per day total are you able to dedicate to training? (in 10-minute increments. ie: total 1 hour)

Thank you for taking the time to complete this form. Consider recording any incidents in chronological order and recording any new information and share with us before or on the day of our next session. As always you can reach us at 760-278-4248 via email at Info@AllBigCanines.com and www.AllBigCanines.com.

The information contained in this form will not be shared with anyone outside of All Big Canines without your express, written, permission.