Canine Behavior Plan

First Name

Last Name

Phone Number

Number of people in your household and ages

Dog's Name

Age

Spayed or Neutered?

What Breed is your dog?

Male or Female

What was the dog's age when you adopted?

Where did you get the dog from?

When did your dog last see their veterinarian? Where there any health issues reported?

Previous adopter, or prior living situation known?

Is your dog currently on any medication?

Are there other pets in the family?

How do you feed your dog (check all that apply)

What are 5 favorite things your dog likes (play fetch, walks, etc.)

What are 5 least favorite things your dog dislikes (baths, storms, visitors, etc.).

What does an average day look like for your dog? Is there a schedule with playtime, walks, etc.

How much time do you spend with your dog daily?

10 minutes

20 minutes

45 minutes

Over an hour

What are 5 least favorite things your dog dislikes (baths, storms, visitors, etc.).

Describe how you play with your dog

How much running or aerobic activity does your dog get on a weekly basis?

Where does your dog sleep?

How much time does your dog spend alone?

Have you used a chain, prong collar or E-Collar?

What other equipment do you use?

Behavior Concern 1, Please describe:

Describe the circumstances that trigger the behavior:

What do you do when your dog exhibits these behavior(s)?

How often does this occur?

How long does it take for your dog to recover?

Behavior Concern 2, Please describe:

Describe the circumstances that trigger the behavior:

What do you do when your dog exhibits these behavior(s)?

How often does this occur?

How long does it take for your dog to recover?

Behavior Concern 3, Please describe:

Describe the circumstances that trigger the behavior:

What do you do when your dog exhibits these behavior(s)?

How often does this occur?

How long does it take for your dog to recover?

Is there anything else you want to mention about your dog's behavior?

Canine Behavior Plan

First Name

Last Name

Phone Number

Number of people in your household and ages

Dog's Name

Age

Spayed or Neutered?

What Breed is your dog?

Male or Female

What was the dog's age when you adopted?

Where did you get the dog from?

When did your dog last see their veterinarian? Where there any health issues reported?

Previous adopter, or prior living situation known?

Is your dog currently on any medication?

Are there other pets in the family?

How do you feed your dog (check all that apply)

What are 5 favorite things your dog likes (play fetch, walks, etc.)

What are 5 least favorite things your dog dislikes (baths, storms, visitors, etc.).

What does an average day look like for your dog? Is there a schedule with playtime, walks, etc.

How much time do you spend with your dog daily?

10 minutes

20 minutes

45 minutes

Over an hour

What are 5 least favorite things your dog dislikes (baths, storms, visitors, etc.).

Describe how you play with your dog

How much running or aerobic activity does your dog get on a weekly basis?

Where does your dog sleep?

How much time does your dog spend alone?

Have you used a chain, prong collar or E-Collar?

What other equipment do you use?

Behavior Concern 1, Please describe:

Describe the circumstances that trigger the behavior:

What do you do when your dog exhibits these behavior(s)?

How often does this occur?

How long does it take for your dog to recover?

Behavior Concern 2, Please describe:

Describe the circumstances that trigger the behavior:

What do you do when your dog exhibits these behavior(s)?

How often does this occur?

How long does it take for your dog to recover?

Behavior Concern 3, Please describe:

Describe the circumstances that trigger the behavior:

What do you do when your dog exhibits these behavior(s)?

How often does this occur?

How long does it take for your dog to recover?

Is there anything else you want to mention about your dog's behavior?