Behavior Questionnaire

Behavioral problems are a common concern for pet owners and can greatly impact the human-animal bond. Particularly with behavioral problems, early detection is essential to achieving the best outcomes. There are a number of strategies we can prescribe to help you reach the best outcomes for you and your pet.

Please complete this questionnaire to help us best understand your pet's health needs.


Client Details

GENERAL INFORMATION

Where did you adopt your pet from?






Age of pet when obtained





Age of pet when the behavioral problem started





ENVIRONMENTAL INFORMATION

Purpose the pet was obtained





Select the type of home you live in







SOCIALIZATION LEVEL

Select the statement that applies to your pet




Select the level of training your pet has received






EXERCISE LEVEL

Select the types of exercise your pet does daily







Number of minutes of exercise your pet gets every day






BEHAVIORAL PROBLEM DETAILS

Select the type of behaviors your pet displays














OTHER CONCERNS

By submitting this form, I acknowledge that I am the owner or agent representing the pet named above and that the information here is true and correct.