Profiling Form

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Behaviour Visit Centre
Home Visit
No Insurance
Pet Plan Insurance
Other Insurance

Please select any of the below boxes if they apply to your dogs general behaviour

S1 Separation anxiety dog upset when alone
S2 Destructive when alone only
S3 Destructive General - anytime
S4 Boisterous behaviour / hyperactivity
S5 Excessive barking when alone
S6 Excessive barking anytime
S7 Barking in a car at people/ at dogs
S8 Excessive attention seeking / any person
S9 Excessive play biting adult / puppy
S10 Frightened of loud sounds / noise phobia
S11 Eating dog faeces, own / other dogs only
S12 Eating faeces: sheep / cow / horse
S13 Jumping up on people anywhere
S14 General food scavenging in the home
S15 General food scavenging outside the home
S16 Recall: dog will not come when called
S17 Submissive urination - puppy / adult
S18 Dominant dog with owner (not aggressive)
S19 General puppy care advice first 25 weeks
S20 Car sickness puppy/adult - drooling, vomiting
S21 New baby introduction to a resident dog
S22 Hyper sexuality ie mounting people / items
S23 Introducing a new cat/ kitten to resident dog
S24 Introducing a new dog /pup to a resident dog
S25 House toilet-training adult/ puppy
S26 Other behaviour

Aggression to People or Dogs

S27 Aggression to dogs only / people only - mainly on a lead
S28 Aggressively chasing domestic animals (predatory)
S29 Aggression to male dogs only
S30 Aggression to female dogs only
S31 Aggression to all dogs either female or male
S32 Aggression to own family dogs only
S33 Aggression to - people territorially
S34 Aggression to people anywhere
S35 Aggression to family members
S36 Aggression to owner food/toy/bone/grooming
S37 Aggression displayed in car at people/dogs

Please Select What Is Appropriate in Relation to Your Dog

House geography and general dog behaviour

House
Flat
Bungalow
Other

Your Family

Your Veterinarian
Yellow Pages
Friend
Internet
Other
Dog
Cat
Other

Please Select What Is Appropriate in Relation to Your Dog

Activity Levels Physiological/Psychological - Please read all questions once and only answer on the second reading

Low
Average
Very Active
Hyper active

Punishment – do you practice the following

Your specific view on the dog behaviour problem

Additional Behaviour Questions

Veterinary/ Medical History

Diet and feeding

Tinned dog food
Dry dog food
Give treats/chews
Other
I have completed this form to the best of my ability and as the owner of said dog. *

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