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Home » Canine Behavioral History

Canine Behavioral History

Name(Required)

First

Last

Phone(Required)

Email(Required)

Are you a current client?(Required)

Yes

No, please contact me to schedule a visit to establish care

Do you have a behavior consult scheduled?

Yes

No, please contact me to schedule

Other

What is the date and time of your scheduled behavior consult?

What is the best phone number to reach you at?(Required)

Who referred you to us?(Required)

Dog's Name(Required)

What is your dog's age and date of birth (or rescue day)?(Required)

How did you acquire your dog and do you have a history of previous care (bought from a breeder at 8 weeks, adopted at 3 years old without previous history, etc)?

Please tell us about any other pets who live in the home (age, sex, neutered, relationship with other pets e.g. plays, fights, ignores).

What tricks can your dog reliably perform (sit, come, touch)?

Does your dog enjoy playing games with you (e.g. fetch, tug)?

All the time

Sometimes

Never

Unsure

How and when do you feed your pets (eg. twice a day in their kennels, once daily with everyone's bowls in the kitchen, etc)?

How is your dog's appetite?(Required)

Always hungry, will eat anything and everything

Will finish meals, enjoys high value treats like meat and cheese but not lower value treats like dry biscuits

Finicky, frequently does not complete meal and only eats really tasty treats

What does a typical work day look like for your dog (how many hours spent alone, outside, in crate)?(Required)

What does a typical weekend/free day look like for your dog (exercise, training, other activities)?(Required)

Does your dog have any concerns with the following? (Select all that apply)(Required)

Unfamiliar dogs when on leash (e.g. during walks)

Unfamiliar dogs when off leash (e.g. at the park)

Cats or other small animals outside of the home

Thunderstorms, fireworks, or other loud noises

Strangers visiting the home or yard

Children

Guarding food, toys, treats

Anxiety when you leave the house

Anxiety when confined in a room or crate

Aggression or fear when being handled (nail trims, grooming)

Jumping up on you or guests

Barking, growling or lunging at bicycles, skateboards, cars or other objects encountered when walking

Pulling hard on leash

Eating non-food items

Destructive behavior (doors, furniture, personal items etc)

Aggression towards other dogs in the home

Undesirable interaction with cats or other small animals in the home

Urination in the house

Defecation in the house

Aggression towards you or other family members

Other

If your dog has any behavior concerns marked above, please elaborate (what is your dog's response, when did the problem start, how often and under what circumstances does your dog respond this way?):(Required)

What are your top 3 concerns about your dog's behavior?(Required)

When did each concern begin and in what situations does it occur?(Required)

What methods have you tried in order to solve your pet's behavioral concerns? (Select all that apply)

Praise for good behavior

Alpha roll/dominance down

Bark collars (citronella or electrical stimulation)

Choker chain, pinch collar, e-collar

Clicker training

Doggie Boot Camp

Kenneling/crating

Leash corrections (sharp jerks on the collar)

Toys or play for good behavior

Making a loud noise

Obedience classes

Physical punishment (e.g. hitting, kicking)

Spraying them with a water bottle or can of air

Treats for good behavior

Yelling “no”

Avoiding situations where the problem occurs

What was your dog's response to each of the above methods you have tried (improved, stayed the same, worsened)?(Required)

Has your dog ever bit or nipped anyone? If, so did this bite require medical attention?(Required)

Does your dog need to be leashed, muzzled, or placed in another room when visitors enter the house?

Yes

Maybe

If the behavior problem does not improve, or worsens, have you considered re-homing or euthanizing your dog?(Required)

Does your dog have any past or current medical concerns?(Required)

What medications (dose and frequency) is your dog currently taking (including names and strengths, nutraceuticals, herbs, and over the counter supplements)?(Required)

What flea/tick/heartworm products is your dog currently taking?(Required)

What is your goal for this appointment?(Required)

Please tell us anything else about your dog or household that you think is important for us to know before our appointment.(Required)

Does your dog have any food restrictions? If so, please let us know what treats (if any) we may use during the appointment.(Required)

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PetDesk

What's Next

1
Call us or schedule an appointment online.
2
Meet with a doctor for an initial exam.
3
Put a plan together for your pet.

Make An Appointment

Where family pets find loving care

Make an appointment

614-360-3941

1117 W 1st Ave,
Columbus, OH 43212

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Our Hospital
Services
Pet Health
New Clients
- New Client Form
- Payment Options
Contact Us
- Request A Refill
- Emergency
Make An Appointment
Online Pharmacy

Monday

8:00am - 7:00pm

Tuesday

8:00am - 7:00pm

Wednesday

8:00am - 7:00pm, Closed 12:30-2:30pm

Thursday

8:00am - 7:00pm

Friday

8:00am - 6:00pm

Saturday

8:00am - 1:00pm

Sunday

Closed

We are open on alternate Saturdays. For more information, Please call us at 614-360-3941.

Canine Behavioral History

What's Next

Call us or schedule an appointment online.

Meet with a doctor for an initial exam.

Put a plan together for your pet.

Where family pets find loving care