Contact details

First Name *

Last Name *

Street Address *

Address Line 2

City *

Phone Number *

Email Address *

Animal Name *

Breed *

Age *

Neutered? *

Yes

Animal History

Main behavioural complaint? *

When did you first notice the behaviour? *

Who/What was the behaviour aimed at *

How do you react? *

How often does it occur? *

Were there any changes in the household when you first noticed the behaviour happening? *

Has anything about the behaviour changed? Describe the last incidence. *

What have you tried to fix the situation? (Do you feel it helped?) *

If any other behavioural complaints please list them.

Does your pet have any current medical conditions? *

Any injuries or pain? Arthritis etc.. *

Why did you choose this pet and breed *

Has your pet been on behaviour modification drugs? If yes, please list them or any other medications they may be on. *

How many times a day is your dog walked? *

What do you use to walk your dog?

Please list any other humans in the household

Please list any other animals in the household.

How many people are involved in your pets life outside of the household? *

Describe your pets typical day. How many hours of that day are you in contact with them? *

Have you attended puppy school?

Have you had advice for behavioural problems in the past? *

Have you attended any other training classes *

What training methods have you used before? *

Positive reinforcement

Negative reinforcement

Verbally telling off

Physical corrections

What type of reinforcement works well for you? *

What do you feed your pet? *

Can you remove food or bones from your dog? *

What are your expectations and goals for treatment? *