Behavioral Questionaire

Name *
Name
Date
Date
What is the main issue you are concerned about
Please check all that apply
Please check any that coincided with the change in your dog's behavior:
If steps have been taken to correct this issue, did your dog's behavior improve, worse or stay the same?
If your dog has threatened or bitten another dog, please check all that apply
IF your dog has threatened or bitten a person, please check all below that apply
Please include the following information: Date of the incident, location, who was present, what other dogs/animals were present, if your dog was on leash, and who was holding the leash. Please also include what preceded the incident, and if your dog gave any warning signals, what were they?
If there was a bite
Did it cause bruising?
Did it cause bleeding?
Was there a puncture wound?
Were there multiple puncture wounds?
Did the dog bite, latch on, and shake his head from side to side, not letting go?
If there was a bite, was medical help sought?
If there was a bite, was it reported?
If there was a bite, was legal action taken?
What best describes your feelings about your dog's behavior issue?