Form

SEE SPOT RUN

Loving Methods. Lasting Results.
Behavior Evaluation Form
Please read all questions. You may skip any that do not apply to your situation, but the more information you supply, the better able we will be to accommodate your dog. If you wish to book a consultation, please indicate the best days/times here.
Type of consultation you wish to schedule*

1/2 hour (free) 1 1/2 hour in-depth ($75) In-home 1 1/2 hour in-depth ($120 and up, depending on your location) Undecided None
Contact Information
Name(s)*
Email(s)*
Phone(s)*
Address*
Dog's Name*
Dog's Age (date of birth if known)*
Sex of Dog*

Male Female
Spay/Neuter Status*

Intact Spayed/Neutered
Breed or Type*
Vaccinations
Are your dog's vaccinations current?*
Veterinarian or Veterinary Hospital with your dog's records on file*
Reason for Behavior Evaluation
What is the main problem or concern?
Please check off any additional issues.

Not housebroken Urinates when excited or afraid Mounts/humps people or objects Jumps up Overactive/doesn't settle easily Nervous or easily stressed Fearful or shy Nuisance barking Demanding barking Chews destructively Bolts through open doors Pulls on leash Doesn't come when called Unresponsive to name or commands Inattentive/short attention span Play biting/mouthing Steals food or objects Guards food, toys or objects Guards people Guards space or territory Aggressive toward people Aggressive toward dogs Growls at family members Has injured one more person Has injured one or more dog Separation Anxiety Other
If guards, please explain.
If aggressive, please explain.
If has bitten or caused injury to a person, please explain.
If has bitten or caused injury to another dog, please explain.
If other, please explain.
Describe the most serious incident that has so far occurred (please note when this happened).
Describe the most recent incident.
How often is the main problem occurring?

Once a month or less No more than once a week Several times a week Every day Multiple times per day
This problem is increasing in

Frequency Intensity Duration None of the above
What have you done to address or correct the above issues? (Please explain when and for how long.)
Were these methods effective? (Please explain.)
What of the above are your most urgent priorities?
What are your long-term goals for your dog?
Do you have a specific training program in mind for your dog?
How did/will you choose a trainer or training program?
How did you find See Spot Run?*
Household Information
How many adults reside in your household? (Please list.)
How many children? (Please list names and ages.)
What other pets do you own?
How many visitors come to the home on average each week?
Is your dog's interaction with any of the above a concern? (Please explain.)
Is this your first dog? If not, please list former dogs by breed.
In what style of home do you live? (House or apartment, how many stories, etc.)
Do you have a yard?
If yes, is it securely fenced?
Do you tie your dog out?
How much time does your dog spend in the yard unattended?
Where does your dog sleep?
Do you crate your dog? If so, when and how does he tolerate it?*
Do you ever confine your dog to a room or area of the house?
How much time does your dog spend loose in the home unattended?
General History
How did you choose your current dog?
Where did you purchase or adopt?
Do you know or were you given information regarding your dog's parents, littermates, or early history?
Is your dog social with new people?*
Is your dog social with other dogs?*
How much social interaction with other dogs has your dog had, either on-leash or off?*
Do you visit dog parks or send your dog to daycare? If so, where and how often?*
Describe your dog's play style or manner of interaction with other dogs?*
Describe the methods you've used to train your dog in the past, including a list of training equipment your dog is familiar with.
If you have worked with a trainer or behaviorist previously, describe what that entailed.*
Check off any commands or skills your dog knows or has.

Sit Down Stay Come Heel Off Leave It Loose-leash Manners Touch Watch Me Out Drop Free Okay Hand Signals Other commands or skills
If hand signals or other commands, please list.
Health History
What do you feed your dog, how often, and how much?*
Is your dog under or overweight?
Does your dog suffer from allergies? (Please explain.)*
Please list any current or recent medications. If current, please give dosage and schedule.*
Has your dog been diagnosed with, or do you suspect, any medical conditions?*
Has your dog ever suffered any serious injuries? (Please explain.)*
Aggression History
If your dog has bitten, was it reported? Please give details.*
Was skin broken, or medical treatment required? Please give details.*
When did you first notice signs of aggression. Please explain.*
Check any known or suspected aggression triggers.*

Stranger approaching Stranger passing Direct or heavy eye-contact Approach or physical contact while eating Approach or physical contact while resting Approach or physical contact while having a toy Verbal correction Leash correction Other physical correction or punishment Approach or presence of children or infants None
Last Words
Is there anything else in your dog's history that we should know?
Please confirm the following:*

I verify all the above answers are accurate to the best of my knowledge.
Should be Empty:

SEE SPOT RUN

Behavior Evaluation Form

Contact Information

Vaccinations

Reason for Behavior Evaluation

Household Information

General History

Health History

Aggression History

Last Words