Hope 4 Your Canine

 

 

Owners Name
Date
How did you hear about us?
Address
Home Phone
Cell Phone
Email
Veterinarian
Dogs Breed
Dogs Name
Dogs Age
Date of Last Rabies Vaccination
Rabies Due on
Is your dog spayed or neutered?
What do you feed your dog?
How much do you feed your dog?
When do you feed your dog?
Has your dog bitten another dog or human?
Does your dog have toys?
Does your dog have a bed?
Do you have cats in the home?
Any other small animals?

 

Please check any of the following behavior issues you wish to discuss

Jumping on People
Marking in the house
Jumping on furniture
Walking on a leash
Barking
Aggression
Fear
Anxiety
Digging


 

When completing the Following profile, assign the following point values to your answers:

Hardly ever: 0-3, Sometimes: 4-6, Almost always: 7-10.

You may not have had the chance to observe all of these behaviors, in which case you leave the answer blank.

When presented with the opportunity, does your dog...
1. Sniff the ground or air?

2. Get along with other dogs?

3. Stand his ground or show curiosity in strange objects or sounds?

4. Run away from new situations?

5. Get excited by moving objects, such as bikes or squirrels?

6. Get along with people?

7. Like to play tug-of-war games to win?

8. Hide behind you when he feels he can’t cope?

9. Stalk cats, other dogs, or things in the grass?

10. Bark when left alone?

11. Bark or growl in a deep tone of voice?

12. Act fearfully in unfamiliar situations?

13. When excited, bark in a high-pitched voice?

14. Solicit petting, or like to snuggle with you?

15. Guards his territory?

16. Tremble or whine when unsure?

17. Pounce on his toys?

18. Likes to be groomed?

19. Guard his food or toys?

20. Cower or turn upside down when reprimanded?

21. Shake and “kill” his toys ?

22. Seek eye contact with you?

23. Dislikes being petted?

24. Act reluctant to come close to you when called?

25. Steal food or garbage?

26. Follow you around like a shadow?

27. Guard his owner(s)?

28. Have difficulty standing still when groomed?

29. Likes to carry things in his mouth ?

30. Play a lot with other dogs?

31. Dislike being groomed or petted?

32. Cower or cringe when a stranger bends over him?

33. Wolf down his food?

34. Jump up to greet people?

35. Likes to fight other dogs ?

36. Urinate during greeting behavior?

37. Likes to dig and/or bury things ?

38. Show reproductive behaviors, such as mounting other dogs?

39. Get picked on by older dogs when he was a young dog?

40. Tend to bite when cornered?

Comments:

 

 

Please enter code, submit below and continue to payment page

This web form is protected from SPAM by SnapHost.com

Enter Captcha code
Captcha Code

 

or