Canine Behavior Services
Behavior Profile for Behavior Consultations

DATE:

Client's name:
Address (street, city, state, zip)

Phone:
Email:

Dog's name:
Breed(s):
Age:
Spayed or Neutered?
If yes, at what age?

Dog acquired from:

Age dog acquired:

List human family members, including ages of any children, in the home:

Anyone outside the home who interacts with the dog on a regular basis?

List breed, sex, ages of other animals in home:

Have you obedience-trained any previous dogs?

How many hours per day indoors?          Outdoors?

How is your dog confined when outdoors?  
Roams free  /  Chained   / Pen (size?    )  /  Fenced Yard (size?     )

How many hours per day alone?

Where does your dog stay when you are gone (what area of house, in a crate or loose, etc)?

Where does your dog sleep at night?

Please detail your dog’s activities (eating, exercise, yard time, walks, playtime, training, etc) on a typical day:

Who grooms the dog? (“Grooming” includes routine brushing, nail clipping, checking/cleaning ears, teeth, etc.)      

How often?

Reaction to grooming : Dog enjoys / tolerates / dislikes
If tolerates or dislikes, describe how:

Amount of time exercised per day?

Type of exercise:

                                                                                                                                                               
Diet - brand and formula:

How often fed/day? 

Is food left out, or picked up after the meal?

Where is your dog fed?

Who feeds?

Is your dog on any medications?

Any current or previous health issues?

Does your dog allow you near his bowl when eating?

Near bones, chews, toys?

What are your dog’s favorite toys?

Favorite games?

Favorite ways to interact with people?

What commands, tricks, etc does your dog know? What percentage of time will he respond to being asked to do these?

How does your dog behave on vet visits? (circles all that apply)
Happy / Calm / Slightly Nervous / Very Nervous / Growls / Barks / Snaps  / Needs to be muzzled

Is your dog doing any of the following things (tick all that apply): 
    Plays keep-away
    Steals items
    Protective of family member(s)
    Alarm Barking
    Boredom Barking
    Other Barking (describe):
    House soiling
    Destroying things
    Jumping on people
    Pulling on leash
    Not coming when called
    Escapes yard
    Running away
    Nipping
    Growling
    Snapping
    Biting
    Fighting with other dogs

Has this dog ever drawn blood in biting a person or dog? (describe briefly):

Please describe the behavior of primary concern for this dog, including when it began occurring, frequency of occurrence, any triggers you are aware of, how you have responded/reacted to the behavior thus far, etc. Please be as detailed as possible.

Detail the most recent incident (include the approximate date):

Detail the second most recent incident (including approximate date):

Detail the third most recent incident (including approximate date):

Please describe any other behavioral concerns:

TRAINING GOALS

Please describe what behavior changes you consider ESSENTIAL for your dog to learn, in order to get along (or remain) in your household:

Please describe what NON-ESSENTIAL commands and behaviors you would enjoy seeing your dog learn and be able to be trained to do:

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