Cat Behavior History Form - Please answer with as much detail as possible.
Name:
Email:
Phone:
Address:
Describe your home:
Own / Rent:
Pet Information
Pet's Name:
Nickname:
Breed:
D.O.B.
Age & sex:
Please indicate spay/neuter
Age altered:
Age obtained:
Color(s):
Obtained from where?
Cost:
Initally shy or outgoing?
Housebroken?
Method of Housebreaking:
Obedienced trained?
Where?
Describe training method used:
Skills the dog is proficient with:
Where does the dog sleep?
Crate trained?
Allow on the furniture?
Fave treat:
What brand of food is fed?
Daily amount:
Who feeds the dog?
Fed table scraps?
Health Information
Clinic/Veterinarian's name:
Vet phone:
Last veterinary appointment:
Reason:
Please describe health history:
List current medications:
Health/medication comments:
List all household members:
Ages of each member:
List type and age of other pets:
Do other current pets have behavior issues? Please explain.
Describe the dog's exercise area:
Describe the dog's daily exercise routine:
How long is the dog exercised each day?
Fave type of play?
Describe the dog's reaction to being left alone:
Describe the dog's behavior upon your returning home:
Is the dog crated?
How long/day?
List the toys the dog has:
Behavior Issue Details
Age the issue was first noticed:
Location:
Describe the event in detail:
What seemed to trigger the behavior?
What was your response?
Describe any punishments:
How often does this behavior occur?
Recent increase?
Any family/home changes recently?
What have you tried so far?
Have you consulted other trainers?
Whom?
If yes, what did they suggest?
Have you considered giving up the dog?
Why haven't you?
What is your goal with this training?
Training budget:
Scheduling Details
What days & times are best?
Alternate:
Detailed driving directions:
How did you hear about us?
Add any additional information here:
Please allow 24-36 hours for a reply. In the meantime, please ask your veterinarian to fax your dog's vaccination paperwork to us at: 603-536-4216