Veterinary Approved Behavioural Specialist and Obedience Trainer

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Profiling Form

Please fill in form below to contact us

Booking Fee
A non-refundable booking fee applies at confirmation of service. This is deducted from your final bill.

Basic Training/Dog Behaviour Training: £100

Puppy Bookings: £75

Type Of Training Required*

Gender*

Age*

Colour*

Appointment Request

Behaviour Visit Centre

Home Visit

Insurance

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

S40 Have you self trained your dog in obedience

S41 Have you consulted with the breeder regarding to your dogs problem(s)

S42 Have you consulted with your veterinarian regarding the behaviour problem

S43 Have you consulted a K9 behaviourist regarding your dog present problem(s)

S44 Have you attended a dog training club with your dog for training

S45 Have you watched any videos / books regarding to your dogs problem(s)

House geography and general dog behaviour

Do you live in a:

House

Flat

Bungalow

Other

S47 Does your dog have access to all rooms in your home

S48 Do you have a garden/patio or other outside play area for you dog

S49 Is your dog allowed to sleep on your bed

S50 Is your dog allowed to sleep in your bedroom

S51 Where does your dog sleep at night in the house

S52 How does the dog behave when you are leaving the house

S53 Is he / she destructive when left unattended or home alone

S54 Does he / she bark when left unattended or home alone

S55 Does he/she defecate or urinate when left unattended or home alone

Your Family

Female owner first name

Male owner first name

Children under 16 years

Age

Gender

Children under 16 years

Age

Gender

Children under 16 years

Age

Gender

Other persons/children living in house

S56 If 10 is deemed a perfect temperament and 0 as a poor what would you mark your dog taking into consideration its behaviour problem in question and that will be presented to the behaviourist.

S57 Did You Contact Us Through:

Your Veterinarian

Yellow Pages

Friend

Internet

Other

S58 Do you have other dogs(s) cat(s) in the house?

Dog

Cat

Other

If yes please write their name and age. If other please describe pet.

Please Select What Is Appropriate in Relation to Your Dog

S59 Does your dog paw or attempt to paw at you

S60 Does your dog lick yours/other peoples hands or face

S61 Does your dog mount people sexually

S62 Does your dog have access to toys, ropes etc in the home territory

S63 Does your dog always greet you on your return home

S64 Does your dog get over hyper/ excited on your return home

S65 Is your dog indifferent to your return home or cannot be bothered

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

S66 What in your view is your dogs activity level -

Low

Average

Very Active

Hyper active

S69 Does your dog have access to dog toys, balls, ropes etc in the home

S70 Will your dog bring toys back to you on command and release them

S71 Does your dog like playing with other dogs he meets

S72 During a walk with your dog do you play any game with/without a toy

S73 Does your dog generally ignore other dogs it encounters

S74 Do you or others play tug -o-war with your dog on ropes and other toys

S75 How long ( in total per day) is your dogs exercise periods Hours / Minutes

Punishment – do you practice the following

S76 Verbally punish the dog if you feel it is required or the dog has misbehaved

S77 Do you isolate the dog if you feel it has misbehaved

S78 Do you physically punish the dog if you feel it has misbehaved

Your specific view on the dog behaviour problem

S79 The problem is very serious and I would like to change it, but if it remains unchanged I will keep my dog (If you answer “yes” ignore questions S80 S81)

S80 The problem is very serious and I would like to change it, but if it remains unchanged I will have to consider re-homing the dog

S81 The problem is very serious and I would like to change it, but if it remains unchanged I will have to consider Euthanasing the dog

Additional Behaviour Questions

S82 Is your dogs history known

S83 From a rescue organisation

S84 From kennel breeder

S85 From a house breeder

S86 Dog from another source

S87 Did you meet the dogs Sire & Dam (parent’s)

S88 Has this dog had other owners

S89 If yes - Why was the dog given up

S90 What age did you acquire the dog

S91 How old was your dog/puppy when it first socialised with other people outside the home

S92 How old was your dog / puppy when it first socialised with other dogs outside the home

Veterinary/ Medical History

S93 Is your dog currently receiving any medication and/or for behaviour problems present

S94 Please describe medication here:

Diet and feeding

S95 Do you feed you dog:

Tinned dog food

Dry dog food

Give treats/chews

Other

S96 How many feeds a day do you give your dog:

Who feeds the dog?

I have completed this form to the best of my ability and as the owner of said dog. *

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