Canine History Form

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In all of the following questions, we will use the term “dog” instead of “dogs” because most people consult us about a single dog. If you have multiple dogs for which you are consulting us, answer all questions about each of them.

DIET AND DAILY ROUTINE

TRAINING EXPERIENCE

DOG'S BEHAVIOR

DOG'S MEDICAL HISTORY

PROBLEM BEHAVIORS

Please be specific and list them in the order of your priorities for training behavioral changes. If you have more than three major problems, just use the last box for more than one problem. The later questions will ask you about the main problem that you would like to work on, so be sure to list that as Problem 1.

Describe examples of this behavior in detail, starting with the more recent incidents. Details such as without treats, corrections, or other interruptions, at how far away does he begin barking? How about with treats? At what distance is he ok but still focused on the person/dog, and what distance is he totally fine? The more details/scenarios you can give, the better.

Thank you for taking the time to complete this form. We look forward to working with you. Now go get yourself something tasty as a reward!

*This Canine Behavior Questionnaire and Aggression Screen have been expanded and modified by Ahimsa Dog Training, Seattle from the original "Canine Behavioral History" form published by the Cornell University College of Veterinary Medicine. Animal Behavior Clinic, College of Veterinary Medicine, Cornell University Ithaca, NY 14853-6401. The Cornell University’s original form may be found at: http://www.vet.cornell.edu/abc/canine_history.htm