Describe a typical 24 hour day in your dog's life, starting with when and where the dog wakes up in the morning. Include feeding, exercise and play times. If behavior problems occur at particular times of the day include that information.
What is the main behavior problem you wish to address at this appointment?
Include where the incident occurred, who else (human and animal) was present, what happened just before the incident, how everyone reacted.
Dog's age (approximate)
Describe per instructions above the most recent incident
Dog's age (approximate)
Describe per instructions above at least one other incident you feel illustrates the problem behavior
Dog's age (approximate)
If you noticed any changes in your dog's body language or facial expression before, during or after the incidents please describe.
What would you like to see as an outcome for your upcoming appointment?
Describe what you've tried to correct the problem and what the dog's response has been to each attempt.
List other problem behaviors in order of importance to you. Due to the intense focus on your dog’s main problem, there may be limited opportunity to address these at the initial appointment.
If yes, describe the victim(s): age, gender, and actions (e.g. 10 year old boy waving stick).
Describe
Comments
If yes, describe incident:
