Reactive Dog – Behavior Class questionnaire Go backYour message has been sent Owner's Name(required) Warning Address(required) Warning Email(required) Warning Phone #(required) Warning Dog's Name(required) Warning Breed(required) Warning Date of birth or Age(required) Warning Gender / Neuter status(required) Intact Male Intact Female Neutered Male Spayed Female Warning Age when neutered or spayed Warning Does your dog have any physical problems that your vet has noted?(required) Warning Is your dog currently on any medication?(required) Warning What's your dog's typical diet / food?(required) Warning Are there any other pets in your household? Do they have any behavior problems?(required) Warning Are there any other people living in the household and what are their relationships with the dog?(required) Warning How old was your dog when you got her/him?(required) Warning Do you have any information about previous owners, breeder set-up, litter mates?(required) Warning Activity Information: How much exercise / how many walks per day?(required) Warning How many training session / play sessions each day and how long?(required) Warning What does your dog in between these activities?(required) Warning How is your dog kept when you leave him/her alone?(required) Warning How many hours per day (daytime) does your dog spend alone?(required) Warning How many hours per day does your dog spend in a crate?(required) Warning Where does your dog sleep?(required) Warning What kind of training / classes has your dog attended?(required) Warning What tricks / behaviors does your dog know?(required) Warning Which of these does your dog find exciting and which are calming?(required) Warning In response to other dogs, does your dog do any of the following behaviors?(required) salivate piddle hide freeze pant pace refuse food if offered bark/growl lunge yawn chase snap/bite/aggress tremble/shake seek out people Warning What specifically triggers this response?(required) Warning How often does your dog encounter them?(required) daily weekly monthly Warning How would you describe your dog's behavioral problem?(required) Warning When did it first occur?(required) Warning Has it progressed?(required) Warning Did it occur suddenly or develop slowly over time?(required) Warning Is the problem always present(required) yes no Warning What has been tried to resolve the problem?(required) Warning Is there anything else you'd like me to know? Warning Warning. Submit Δ Share this: Click to email a link to a friend (Opens in new window) Email