Client Name
Date
Pet Name
Breed
Age/DOB
Sex
Male
Female
Spayed/Neutered
Primary Veterinarian / Clinic
Where did you acquire your dog?
Breeder
Shelter / Rescue
Friend / Family
Stray
Other:
Age when acquired
Who lives in the household? (Include adults, children with ages, and other pets):
Daily Routine & Environment
Hours spent alone daily
Where is the dog kept when alone?
Crate
Designated Room
Free Roam Inside
Outside Yard
Primary sleeping location
Exercise frequency & duration
What are the primary issues you would like to address today? (Check all that apply)
Aggression toward strangers
Aggression toward family members
Aggression toward other dogs / animals
Separation anxiety / Distress when left alone
Excessive barking / Vocalization
Fear, anxiety, or phobias (e.g., fireworks, thunder, vet visits)
Resource guarding (food, toys, objects, locations)
Inappropriate elimination / House-training issues
Destructive chewing or digging
Leash reactivity (lunging, barking while on walk)
Other:
Describe the main issue in detail: (When did it start? How often does it occur? What triggers it?)
If aggression or reactivity is present, complete this section. Otherwise, skip to Section 4.
Has your dog ever growled, snapped, or bitten anyone?
If yes, please describe the incident(s), including whether contact skin was broken:
Identify known triggers: (Check all that apply)
Reaching for collar / Touching body
Approaching food bowl / High-value treats
Approaching toys or resting spots
Strangers entering the home
Approached by unknown dogs on leash
High-pitched sounds / Fast movements (e.g., running children)
Grooming / Handling (paws, ears, nails)
How would you rate your dog’s general energy level?
Low / Couch potato
Moderate
High
Hyperactive / Hard to settle
How does your dog react to novel situations, places, or objects?
Curious / Confident
Cautious / Hesitant
Fearful / Hiding
Reactive / Barking
Does your dog display signs of anxiety? (e.g., panting, pacing, drooling, trembling, lip licking, tail tucked)
Frequently
Occasionally
Rare / Never
Specific triggers
Has your dog attended formal obedience or training classes?
If yes, what style or methodology was used?
Commands your dog reliably knows
Sit
Down
Stay
Come / Recall
Leave It
Place
Current equipment used for walks
Flat collar
Back-clip harness
Front-clip harness
Head halter / Gentle Leader
Slip lead / Other
How do you typically correct or manage unwanted behavior?
Current diet & feeding schedule
Known medical conditions, chronic pain, or medications:
Has there been a recent sudden change in behavior?
If yes, explain
Form Template Insights
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Collecting full demographics and home dynamics establishes a baseline of the dog's daily reality. Age, breed, and spay/neuter status provide vital biological context, as sexual maturity and breed-specific genetic traits strongly influence behavioral onset. Documenting household members, hours left alone, and sleeping locations identifies environmental stressors, routine instability, or overcrowding that directly fuel anxiety or frustration.
A comprehensive list of targeted check-boxes prevents clients from underreporting subtle issues while focusing on the most pressing behaviors. Asking owners to articulate specific triggers, timelines, and frequency forces them to move past subjective descriptions like "my dog is bad" and provide objective observational data. This distinction allows practitioners to differentiate between general fear, learned frustration, and situational reactivity right from the start.
Detailing past biting incidents, skin contact, and specific triggers helps classify the exact nature of the aggression—whether fear-based, territorial, or resource guarding. Pinpointing exact triggers like reaching for collars, approaching food, or encountering strangers on-leash allows clinicians to construct immediate safety protocols and management plans before starting any behavioral modification work.
Evaluating baseline energy levels, novel object responses, and subtle body language signals—such as panting, pacing, or lip licking—reveals the dog's overall emotional resilience. Distinguishing between a high-energy dog lacking enrichment and a chronically anxious dog struggling with nervous system dysregulation ensures the resulting management plan targets the root emotional state rather than just the outward symptom.
Understanding past training methods and current walking equipment reveals how the dog has been communicated with and handled. It highlights potential fear associations created by past corrections and identifies whether equipment like flat collars or head halters are contributing to leash reactivity. Knowing known commands gives practitioners immediate leverage points for positive redirection.
Behavioral shifts are frequently tied to underlying medical conditions, undiagnosed chronic pain, or nutritional imbalances. Documenting recent behavioral changes, current diets, and active medications ensures veterinary teams rule out physical causes—such as musculoskeletal pain or thyroid dysfunction—before attributing behavioral issues strictly to psychological factors.
Mandatory Questions Recommendation
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