Veterinary Behaviour Questionnaire – Dog Veterinary Behaviour Questionnaire - Dog "*" indicates required fields Δ Step 1 of 29 - Introduction 3% Introduction Thank you for your interest in seeing one of our behaviour vets. Please take the time to fill out this form so that your behaviour vet can familiarise themselves with your pet's case and start preparing before they see you. Please provide honest and complete answers, giving as much detail as possible that fits in the space provided. We will ask you for more detail during the consultation if required. Although some questions may seem irrelevant to your pet’s situation, please take the time to provide thoughtful answers to ALL the questions. Please be as truthful as possible; we are not here to judge you, but to help you! It is very important that you DO NOT TEST OR PROVOKE YOUR PET if you are unsure of any of the answers. This form can take some time to complete, with multiple sections. If you need a break, you can save your form and come back later to finish it. Your answers will only be saved when you go to the next page, or click "Save". Privacy Consent*Pet Behaviour Vet requires the Personal Information of you, your pet and your family and other people you live with in order to provide our services to you. All personal information is handled in accordance with our Privacy Policy. I agree to the privacy policyTerms, Conditions and Treatment Consent Policy*Pet Behaviour Vet requires your consent to treat your Pet, in accordance with our Terms, Conditions and Treatment Consent Policy. Please read through this thoroughly as it contains important information about our practice policies that we need you to understand and agree to. I agree to the Terms, Conditions and Treatment Consent Policy Client Contact DetailsOwner's Name* Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. Prefix First Last Preferred phone number*Address Street Address Address Line 2 City New South WalesQueenslandVictoriaAustralian Capital TerritoryTasmaniaSouth AustraliaNorthern TerritoryWestern Australia State/Territory Postcode Email* How did you find out about us?Referree name and company (if applicable) Your HouseholdList all owners and people who live with your pet, including yourself (click the blue '+' to add extra lines)Relationship to person filling in formTitleFull NameAgeOccupation Add RemoveAre there any additional members of the household who live here part-time or who live on the property and have regular contact with your pet? If yes, give details:Do you have other pets in the home?*select an option:YesNoList all other pets in the home, that the patient has contact with: (click the blue '+' to add extra lines)NameSpeciesBreedAgeSexDesexed (Y/N) Add Remove Patient DetailsPet's name*Legal owner's name (as per microchip and registration)*Date of Birth* DD slash MM slash YYYY Is this DOB exact or estimated?select an option:ExactEstimatedBreed*Is Breed known or guessed?select an option:knownguessedWeight (kg)Sex*select an option:MaleFemaleDesexed?*select an option:YesNoAge at desexingWere they desexed for behavioural reasons? If yes, explain:If your pet is an un-desexed female, when was her last heat and how often does it occur? Do you notice any behaviour changes when she is in heat? Early HistoryWhere did you get your pet from?Age or Date acquiredTime spent with previous owner(s) and their reasons for rehoming (if known)Number of littermatesAge separated from littermatesAge separated from motherWere they ever bottle-fed or hand-raised?select an option:YesNoDon't knowDescribe personality of siblings and parents. Did you meet them? What was the setup and conditions of the breeding environment or previous owner's home?Do any of their relatives have health or behaviour problems? SocialisationIn their FIRST 4 MONTHS of life, how much exposure did your pet have to UNFAMILIAR PEOPLE, DOGS and OTHER SPECIES? Were these experiences positive or negative?Between the age of 5-12 months, how much exposure did your pet have to UNFAMILIAR PEOPLE, DOGS and OTHER SPECIES? Were these experiences positive or negative?In their FIRST 4 MONTHS of life, how much exposure did your pet have to UNUSUAL OCCURRENCES? Were these experiences positive or negative?Eg. storms, fireworks, holidays, vets, car rides, illnesses, etcBetween the age of 5-12 months, how much exposure did your pet have to UNUSUAL OCCURRENCES? Were these experiences positive or negative?Eg. storms, fireworks, holidays, vets, car rides, illnesses, etc Medical HistoryUsual vet clinic name*Preferred clinician at usual vet clinicPrevious clinics you have been to where medical records held (click the blue '+' to add extra lines) Add RemoveIs your pet covered by pet insurance?*select an option:Yes, and covered for behaviourYes, but not covered for behaviourYes, but unsure if covered for behaviourNoIs your pet CURRENTLY taking behavioural medications, sedatives, pheromones (Adaptil), over-the-counter supplements, herbal or homeopathic remedies specifically for behavioural reasons, either daily or occasionally?*select an option:YesNoCURRENT BEHAVIOURAL MEDICATIONS (click the blue '+' to add extra lines)Ingredient / brandStrength (mg, mg/mL)How many each dose? (3 tabs, half tab, 0.75mLs)How often? (once a day, twice a day, only for storms)Dates/duration given (regularly for past 2yrs, tried only once...) Add RemoveDescribe their effect on your pet's behavioureg. big improvements, mild improvements, no change whatsoever, side effects such as... Has your pet PREVOUSLY taken behavioural medications, sedatives, pheromones (Adaptil), over-the-counter supplements, herbal or homeopathic remedies specifically for behavioural reasons, either daily or occasionally?*select an option:YesNoPREVIOUS BEHAVIOURAL MEDICATIONS (click the blue '+' to add extra lines)Ingredient / brandStrength (mg, mg/mL)How many each dose? (3 tabs, half tab, 0.75mLs)How often? (once a day, twice a day, only for storms)Date of last dose, duration given (regularly for past 2yrs, last given 30 days ago) Add RemoveDescribe their effect on your pet's behaviour (eg. big/small improvements, no change whatsoever, side effects such as... ) and why they were discontinued.List any current and previously diagnosed medical conditionsList any food allergies or food that your pet is not allowed to eatDoes your pet have any of the following conditions or symptoms? Blindness Deafness Permanent injury Neck of back pain Arthritis or joint disease Regular itching Ear infections Dental disease, plaque, tartar Regular or occasional limping Vomiting (more than once a month) Diarrhoea (more than once a month) Other chronic pain or disease Do any of the above health conditions affect your pet's behaviour when they are experiencing symptoms? Give details:Eg. they are more reactive when they are itchy, more aggressive when they are painfulIs your pet CURRENTLY on any other medications, including flea/tick/worming products, over-the-counter supplements, herbal or homeopathic remedies?*select an option:YesNoCURRENT 'OTHER' MEDICATIONS (click the blue '+' to add extra lines)Ingredient / brandStrength (mg, mg/mL)How many each dose? (3 tabs, half tab, 0.75mLs)How often? (once a month, twice a day, as needed)Dates/duration given (last month, regularly for past 2yrs, week-long course only) Add Remove Food and DietWhat kind of food do you feed your pet at set meal times (eg/ breakfast and dinner)? Include brand names if possibleAt what time of day is your pet fed its meals?Location fedDoes your pet eat:select an option:Very slowlyNormal paceQuicklyRavenouslyAppetite variesDoes your pet eat:select an option:only when owner is home, but they can be in another roomonly when owner is within direct line of sightonly in privacy, when nobody is watchingat any time, they aren't bothered by people's presenceDoes your pet:select an option:start and finish all their food as soon as it is givenignore the food at first, then come back later and eat it allimmediately eat some of the food, then leave and come back to finish the rest latereat some of the food, and doesn't ever finish the restWhat kind of bowl or food-dispensing toy do you feed your pet out of?Eg. kong, slow feeder bowl, plain bowlIf more than one pet, what are the feeding arrangements (eg. how far apart are they fed, do they share bowls, do you need to separate them)?Does your pet bury (or pretend to bury) its food, treats or toys?select an option:Yes, oftenYes, occasionallyNoList your pet’s top 3 favourite foods/treats that they will ‘do anything for’:When PEOPLE approach your pet when they are eating, does your pet ever look scared, eat faster, show aggression or run away?*select an option:YesNoWhen OTHER ANIMALS approach your pet when they are eating, does your pet ever look scared, eat faster, show aggression or run away?*select an option:YesNo TrainingHas your pet ever had a FORMAL/PAID training class or behaviour consultation (either in a private session, group class or dog sports?)*select an option:YesNoDid your pet go to Puppy Preschool / Puppy Group Training classes?*select an option:YesNoStarting at what age?Location / Trainer name:Was your pet focussed and able to learn in the class? Did they experience any behavioural problems there? Please explain:Are you currently seeing a trainer, animal behaviourist or veterinary behaviourist for advice or classes?*select an option:YesNoPlease tell us their name or company name and suburbWhen and for what reason did you hire them? What were the main recommendations made, and what changes, if any, did you observe as a result?Have you seen any other trainers, animal behaviourists or veterinary behaviourists for advice or classes in the past?*select an option:YesNoPlease tell us their name or company name and suburbWhen and for what reason did you hire them? What were the main recommendations made, and what changes, if any, did you observe as a result?Has your pet been to any other regular obedience or specialised classes?*e.g. Agility, Flyball, Nosework etc.select an option:YesNoPlease describe the classes. Was your pet focussed and able to learn in the class? Did they experience any behavioural problems there?Do you do any informal training at home on a regular basis? If yes, describe what you do, who does the training, how often, what works or doesn’t work?*What kind of rewards, punishments, discipline or strategies do you use on your pet when they do something you don't want them to do?*Describe your pet’s reaction to any punishment or reprimands given (if any). Have they ever growled or bitten in response to being punished?*Please give details. DO NOT TEST YOUR PET if you're not sure. ExerciseWhat exercise does your pet receive on an average week? (click '+' to add extra lines for each activity)Type (eg walk, run, training class)How often per week?How long is each session?Who takes them? Add RemoveWhat does your dog do when they see you pick up the lead, or when you try to clip on the lead / harness?Describe your dog’s behaviour and body language when in public?*e.g. Do they sniff, explore, pull like a steam train, startle easily, try to run and hide, wag tail, tuck tail, walk on a loose leash, refuse to take treats, respond well, etcWhat sort of distractions cause your dog to pull tight AND not listen to you when on leash, and how often?* PlayDoes your pet ever initiate play with people?select an option:YesNoWill your pet engage when people initiate play first?select an option:YesNoFor how long will they play any game each day?What kinds of toys does your pet have and which are its favourite? Have you ever used food-dispensing toys (eg/ kong) and did they understand how to use them?Do they destroy their toys if given the chance?select an option:Yes, within one sessionYes, eventually after a few sessionsNo, their toys can last a long timeDo they ever ingest any pieces?select an option:YesNoList your pet's top 3 favourite things OTHER than food: Sleeping and RestingWhat's your pet's favourite location to sleep at NIGHT?How many hours do they sleep every NIGHT?Do they ever get into a deep sleep (side sleeping, dreaming) at NIGHT?select an option:Yes, every nightYes, sometimesI almost never see thisHow many times do they wake through the night, and do you suspect a reason?How many times a week does this happen?What's your pet's favourite location to sleep or rest in the DAYTIME?For how many hours do they get into a deep sleep (side sleeping, dreaming), in the DAYTIME?Do they get off the bed or couch when asked?select an option:Yes, alwaysYes, but I have to ask multiple timesRarelyN/A, they aren't allowed on the bed/couchDoes your pet ever look scared, show aggression or try to hide from PEOPLE who come near their resting place?*select an option:YesNoDoes your pet ever look scared, show aggression or try to hide from ANIMALS who come near their resting place?*select an option:YesNo ToiletingWhat is your pet’s usual/preferred toileting location for URINE?What is your pet’s usual/preferred toileting location for FAECES?Where would YOU prefer that they toilet?Are there any toileting accidents when not given access to this spot, and if yes, how often?Can they hold their bladder/bowels for several hours at a time (e.g. overnight)?select an option:Yes, alwaysYes, usuallyNoHow many times PER WALK does your pet URINATE when out in public?How many times PER WALK does your pet DEFAECATE when out in public?Is your pet ever incontinent with urine or faeces when excited, scared or resting? If yes, how often and what are the triggers, if known? SeparationWhen you are home, what part of the house or yard is your pet given access to?Does your pet follow any of you around the house excessively? Do they choose to spend any time alone away from people?What does your pet do when the LAST person prepares to depart (get dressed, pick up keys, pack bag, etc)? Include details of whether they eat, drink, sleep, play or show signs of distress.*(such as barking, pacing, escaping, destruction, panting, aggression or anything else relevant).Is your pet’s behaviour any different between members of the family? How?What does your pet do if one person is leaving and another is still at home?When your pet is alone, what part of the house or yard do they have access to?Describe any toys, foods or activities that are left out while your pet is left alone, and whether they actually engage with them:For how many hours per day, and days per week are they left alone without humans?Describe your pet’s behaviour and body language (if known) when they are left alone without human company.*Include details of whether they eat, drink, sleep, play or show signs of distress (such as barking, pacing, escaping, destruction, panting, waiting expectantly at the door, or anything else relevant).How do you know? (e.g. petcam, neighbours)How long after you leave do they start showing signs of distress, and when do they eventually relax?Do they behave differently if it is a routine departure (eg. work) vs. other outings (eg. out to dinner)?select an option:No, behaviour is similar for all outingsThey are worse for routine outings (like work)They are worse for non-routine outings (like going out to dinner)It's random and I can't predict their behaviourDo they get distressed when separated from other pets in the household?select an option:YesNoHaven't tried / Don't knowN/AWhat does your pet do when people arrive home and how long does it take for them to relax again?*How do they cope with boarding / day care / hospitalisation at vets? Aggression towards PeopleHas your pet EVER bared its teeth, growled, lunged at, air-snapped, mouthed or bitten any PERSON, whether accidentally or intentionally?*select an option:YesNoTick ALL types of bites or threats that your pet has ever directed towards a PERSON:* Growling or teeth baring, but no bite or lunge Lunge or air snap – no contact with skin or clothes at all Mouthing – very soft bite with no pressure, teeth touching skin but no injury Bite – dent left on skin or bruising, or grabbed clothes. No broken skin Bite – broken skin with shallow/small punctures Bite – broken skin with deep puncture or tearing If your pet has bitten before, have they ever held on for more than half a second?*select an option:YesNo, neverIf your pet has bitten before, have they ever tried to shake their head while holding on?*select an option:YesNo, neverHave they ever gone back for, or attempted to go back for a second bite?*select an option:YesNo, neverDescribe the 3 most serious incidents, in as much detail as possible.*Include what occurred immediately beforehand, your dog’s body language at the time, the type of injury, and how the victim and witnesses responded.Aggression triggersIn which of the following instances has your pet shown aggression? Aggression includes bearing teeth, growling, lunging, air snapping, mouthing and biting. DO NOT TEST YOUR DOG IF YOU ARE UNSURE.Adult Family Members Seen or heard at property boundary Standing/knocking at front door After walking through front door Walking back into room after leaving the room Making sudden movements or shifting your body weight when seated In response to noise eg/ thunder Touching/bumping pet while they are resting but awake Touching/bumping pet while they are in a deep sleep Walking nearby where pet is resting Asking pet to get off couch/bed Taking a toy or object out of their mouth Touching a toy or object that is lying nearby on the floor Walking nearby while pet is playing with toy During play with your pet Taking food or bone out of mouth Touching food or bone that is lying near your pet on the floor Walking nearby while pet is eating normal meal Walking nearby while pet is eating bone or chew Walking nearby an empty food bowl Walking near where food/bone has been buried Being near kitchen or pet’s food preparation area When asking them to wait for food/treat Shouting or acting silly (cheering, drunk, cartwheels) Running Riding bikes, skateboards etc Walking past at a distance (across rd) Walking past close by (same side of rd) Being in the same room, unprovoked Leaning or bending over them Looking or staring at them Petting them Hugging them Brushing them Bathing them Clipping their nails Picking them up Grasping their collar Fitting harness, collar or lead Tugging, correcting or ‘checking’ on lead Verbally reprimanding or raising voice Physically punishing them Touching body in a particular area Child Family Members Seen or heard at property boundary Standing/knocking at front door After walking through front door Walking back into room after leaving the room Making sudden movements or shifting your body weight when seated In response to noise eg/ thunder Touching/bumping pet while they are resting but awake Touching/bumping pet while they are in a deep sleep Walking nearby where pet is resting Asking pet to get off couch/bed Taking a toy or object out of their mouth Touching a toy or object that is lying nearby on the floor Walking nearby while pet is playing with toy During play with your pet Taking food or bone out of mouth Touching food or bone that is lying near your pet on the floor Walking nearby while pet is eating normal meal Walking nearby while pet is eating bone or chew Walking nearby an empty food bowl Walking near where food/bone has been buried Being near kitchen or pet’s food preparation area When asking them to wait for food/treat Shouting or acting silly (cheering, drunk, cartwheels) Running Riding bikes, skateboards etc Walking past at a distance (across rd) Walking past close by (same side of rd) Being in the same room, unprovoked Leaning or bending over them Looking or staring at them Petting them Hugging them Brushing them Bathing them Clipping their nails Picking them up Grasping their collar Fitting harness, collar or lead Tugging, correcting or ‘checking’ on lead Verbally reprimanding or raising voice Physically punishing them Touching body in a particular area Regular / Known Visitors Seen or heard at property boundary Standing/knocking at front door After walking through front door Walking back into room after leaving the room Making sudden movements or shifting your body weight when seated In response to noise eg/ thunder Touching/bumping pet while they are resting but awake Touching/bumping pet while they are in a deep sleep Walking nearby where pet is resting Asking pet to get off couch/bed Taking a toy or object out of their mouth Touching a toy or object that is lying nearby on the floor Walking nearby while pet is playing with toy During play with your pet Taking food or bone out of mouth Touching food or bone that is lying near your pet on the floor Walking nearby while pet is eating normal meal Walking nearby while pet is eating bone or chew Walking nearby an empty food bowl Walking near where food/bone has been buried Being near kitchen or pet’s food preparation area When asking them to wait for food/treat Shouting or acting silly (cheering, drunk, cartwheels) Running Riding bikes, skateboards etc Walking past at a distance (across rd) Walking past close by (same side of rd) Being in the same room, unprovoked Leaning or bending over them Looking or staring at them Petting them Hugging them Brushing them Bathing them Clipping their nails Picking them up Grasping their collar Fitting harness, collar or lead Tugging, correcting or ‘checking’ on lead Verbally reprimanding or raising voice Physically punishing them Touching body in a particular area Adult Strangers Seen or heard at property boundary Standing/knocking at front door After walking through front door Walking back into room after leaving the room Making sudden movements or shifting your body weight when seated In response to noise eg/ thunder Touching/bumping pet while they are resting but awake Touching/bumping pet while they are in a deep sleep Walking nearby where pet is resting Asking pet to get off couch/bed Taking a toy or object out of their mouth Touching a toy or object that is lying nearby on the floor Walking nearby while pet is playing with toy During play with your pet Taking food or bone out of mouth Touching food or bone that is lying near your pet on the floor Walking nearby while pet is eating normal meal Walking nearby while pet is eating bone or chew Walking nearby an empty food bowl Walking near where food/bone has been buried Being near kitchen or pet’s food preparation area When asking them to wait for food/treat Shouting or acting silly (cheering, drunk, cartwheels) Running Riding bikes, skateboards etc Walking past at a distance (across rd) Walking past close by (same side of rd) Being in the same room, unprovoked Leaning or bending over them Looking or staring at them Petting them Hugging them Brushing them Bathing them Clipping their nails Picking them up Grasping their collar Fitting harness, collar or lead Tugging, correcting or ‘checking’ on lead Verbally reprimanding or raising voice Physically punishing them Touching body in a particular area Child Strangers Seen or heard at property boundary Standing/knocking at front door After walking through front door Walking back into room after leaving the room Making sudden movements or shifting your body weight when seated In response to noise eg/ thunder Touching/bumping pet while they are resting but awake Touching/bumping pet while they are in a deep sleep Walking nearby where pet is resting Asking pet to get off couch/bed Taking a toy or object out of their mouth Touching a toy or object that is lying nearby on the floor Walking nearby while pet is playing with toy During play with your pet Taking food or bone out of mouth Touching food or bone that is lying near your pet on the floor Walking nearby while pet is eating normal meal Walking nearby while pet is eating bone or chew Walking nearby an empty food bowl Walking near where food/bone has been buried Being near kitchen or pet’s food preparation area When asking them to wait for food/treat Shouting or acting silly (cheering, drunk, cartwheels) Running Riding bikes, skateboards etc Walking past at a distance (across rd) Walking past close by (same side of rd) Being in the same room, unprovoked Leaning or bending over them Looking or staring at them Petting them Hugging them Brushing them Bathing them Clipping their nails Picking them up Grasping their collar Fitting harness, collar or lead Tugging, correcting or ‘checking’ on lead Verbally reprimanding or raising voice Physically punishing them Touching body in a particular area Unfamiliar People In PublicDescribe your dog’s behaviour and body language when they see UNFAMILIAR PEOPLE across the road or further away when you are walking them in public.*Describe your dog’s behaviour and body language when these people get closer and approach your dog while your dog is on leash.*Describe your dog’s behaviour and body language when seeing unfamiliar people while your dog is playing off-leash.*If any of these situations are problematic, what works best to manage the above behaviours? Unfamiliar People at HomeDescribe your dog’s behaviour and body language when they can hear or see people at the boundaries of your house. How many times a day do they react and for how long?*Describe your dog’s behaviour and body language when your doorbell rings or when they hear a knock at the door.Describe your dog’s behaviour and body language when visitors first walk through your front door into your home.*Describe your dog’s behaviour and body language while visitors are in your home. Can they relax and fall asleep like normal? Do they react when they make a sudden noise or movement?*If any of these situations are problematic, what works best to manage the above behaviours?* Aggression towards DogsHas your pet EVER bared its teeth, growled, lunged at, air-snapped, mouthed or bitten ANY DOG, whether accidentally or intentionally?*select an option:YesNoTick ALL types of bites or threats that your pet has ever directed towards a DOG:* Growling or teeth baring, but no bite or lunge Lunge or air snap – no contact with skin or fur at all Mouthing – very soft bite with no pressure, teeth touching skin but no injury Bite – dent left on skin or bruising, or grabbed clothes. No broken skin Bite – broken skin with shallow/small punctures Bite – broken skin with deep puncture or tearing Bite - causing death If your pet has bitten a dog before, have they ever held on for more than half a second?*select an option:YesNo, neverIf your pet has bitten a dog before, have they ever tried to shake their head while holding on?*select an option:YesNo, neverHave they ever gone back for, or attempted to go back for a second bite?*YesNo, neverDescribe the 3 most serious incidents, in as much detail as possible. Include what occurred immediately beforehand, each dog’s body language at the time, the type of injury on both dogs (if any), and how the victim and witnesses responded.* Unfamiliar Dogs in PublicDescribe your dog’s behaviour and body language when they see unfamiliar DOGS across the road or further away when you are walking them in public.*Describe your dog’s behaviour and body language when these DOGS get closer and approach your dog while your dog is on leash.*Describe your dog’s behaviour and body language when seeing unfamiliar DOGS while your dog is playing off-leash.*Describe your dog’s behaviour and body language they can hear or see DOGS at the boundaries of your house. How many times a day do they react and for how long?*If any of these situations are problematic, what works best to manage the above behaviours?* Other Pets at HomeDoes your pet play appropriately with other dogs or cats in the household? Who initiates the play and how often? Do they enjoy each other’s company and/or sleep next to each other?*Do you see any concerning behaviour (such as aggression, bullying, chasing or avoidance) between the patient and other pets in the home? Include any triggers that may cause your dog to show these behaviours, such as eye contact, other pet walking into the room, food, toys, etc.*If problematic, what works best to manage the above behaviours?* CatsHas your pet EVER bared its teeth, growled, lunged at, air-snapped, mouthed or bitten any CATS, whether accidentally or intentionally?*Select an option:No, neverYesTick ALL types of bites or threats that your pet has ever directed towards a CAT:* Growling or teeth baring, but no bite or lunge Lunge or air snap – no contact with skin or fur at all Mouthing – very soft bite with no pressure, teeth touching skin but no injury Bite – dent left on skin or bruising, or grabbed clothes. No broken skin Bite – broken skin with shallow/small punctures Bite – broken skin with deep puncture or tearing Bite- causing death If your pet has bitten a cat before, have they ever held on for more than half a second?*select an option:YesNo, neverIf your pet has bitten a cat before, have they ever tried to shake their head while holding on?*select an option:YesNo, neverHave they ever gone back for, or attempted to go back for a second bite?*select an option:YesNo, neverDescribe the most serious incident, in as much detail as possible. Include what occurred immediately beforehand, each animal's body language at the time, the type of injury on both animals (if any), and how the victim and witnesses responded.* WildlifeWhat does your pet do when they see wildlife at your fence or window at home?What does your pet do when they see wildlife when out in public while on a walk?If problematic, what works best to manage the above behaviours? NoisesDoes your pet act any differently to normal during thunderstorms, wind, rain, fireworks displays, or in the presence of very loud noises?*select an option:YesNoDescribe your pet’s behaviour and body language during STORMS. Does it start well before the storm arrives, or only in direct response to the thunder? Describe what you do to help them settle, if applicable.*Describe your pet’s behaviour and body language during FIREWORKS displays. Describe what you do to help them settle, if applicable.*Describe your pet’s behaviour and body language in response to OTHER LOUD NOISES, such as artillery fire, electronic beeping, loud traffic, power tools, doors slamming.*Does your pet respond DISPROPORTIONATELY to normal everyday noises around the house, such as dropping a pen, doing the dishes, the sound of light rain, scuffing your feet, or coughing? If yes, explain:* Husbandry Procedures and Stressful OutingsDoes your pet become fearful, anxious, aggressive or stressed during vet visits?*select an option:YesNoDescribe their behaviour and body language during vet visits:Does your pet’s behaviour prevent your vet from being able to perform a thorough physical exam and minor procedures (like ear cleaning, taking blood, giving injections)?*select an option:Yes, regularlyYes, occasionallyNoDoes your pet become fearful, anxious, aggressive or stressed when being groomed, bathed or when having their nails trimmed?*select an option:YesNoDescribe their behaviour and body language when being groomed, bathed or when having nails trimmed:Does your pet’s behaviour prevent you or your groomer from being able to perform these tasks?*select an option:Yes, regularlyYes, occasionallyNoIs your pet usually able to relax and eventually fall asleep when travelling in the car?*select an option:Yes, regularlyOnly sometimesNo, neverDescribe their behaviour and body language on both long and short car rides: Repetitive BehavioursDoes your pet lick themselves, objects or people excessively?*select an option:YesNoDescribe what exactly they do, when it occurs, how often, how long it continues for, what works to stop the behaviour and what you think might be a trigger.Does your pet perform any repetitive behaviours such as spinning, pacing, shadow/light chasing, or biting at imaginary flies in the air?*select an option:YesNoDescribe what exactly they do, when it occurs, how often, how long it continues for, what works to stop the behaviour and what you think might be a trigger.Does your pet regularly swallow, chew or suck on non-food items (such as faeces, soil, rocks, fabric or plastic)?*select an option:YesNoDescribe what exactly they do, when it occurs, how often, how long it continues for, what works to stop the behaviour and what you think might be a trigger. Age-related problemsIs your pet 8 years of age or older?*select an option:YesNoDoes your pet:tick ALL that apply ever get ‘lost’ in familiar places, tight spaces or corners? prefer to be asleep in the daytime but awake at night? pace or seem restless at night? stare blankly at walls, the floor or into space for long periods? seem to have become more anxious in their old age? Has your pet:Tick ALL that apply been spending more time resting and avoiding exercise recently? forgotten basic skills such as toilet training or obedience that they knew as a younger dog? lost interest in playing games or with toys? lost interest in social interaction with people and other pets? Formal ComplaintsHas your pet’s behaviour ever been reported to the council or police for its behaviour? If yes, give details:*Have you ever been issued with a Control Order, Nuisance Order, Menacing Dog Order, or Dangerous Dog order for your dog? If yes, give details*Have you have neighbours complain to you about your pet's behaviour? If yes, give details.* Additional InformationList any other situation that we have not mentioned in this questionnaire which causes your dog to act differently to normal, and the body language and behaviour you see when this occurs:Is there anything else that you would like to tell us about your pet’s behaviour that was not addressed in this form? Looking ForwardList your SHORT-TERM and URGENT goals that you would like addressed during your first visit with us*Click the '+' to add more lines Add RemoveList your LONG-TERM, LESS URGENT goals that you would like to work towards in the futureClick the '+' to add more lines Add RemoveWhat will you do if these goals cannot be met, or if your pet’s problems don’t ever improve?At what point would you seriously consider removing your pet from your household (rehoming or euthanasia)?And lastly, tell us something POSITIVE about your pet! What do they do that you love, that makes you smile?
