Behavioral Assessment-DOG

DOG'S NAME

BREED:

CURRENT AGE:

Why do you want to relinquish your dog?

Has your dog bitten or scratched anyone in the last 10 days?

Has your dog ever bitten someone and broken skin?

Date of last bite (if applicable):

If yes, please describe the circumstances surrounding the bite or type n/a if no bite has taken place:

How old was your dog when you obtained him/HER?

From where did you obtain the dog?

If Rescue Group/Shelter, which one?

Has your dog ever shown any of the following behaviors? (check all that apply)

GENDER

SPAYED/NEUTERED?

Where does your dog spend most of his day?

How many hours per day is your dog alone?

Where does your dog spend the night?

What is your dog's exercise routine?

Is your dog housetrained?

Under what circumstances might your dog have an accident?

Has your dog been through any obedience training?

What commands does your dog know?

What language?

Has your dog ever been introduced to a crate?

Has your dog ever escaped from your yard or your house?

If yes, please explain the circumstance:

What brand/type of dog food does your dog eat? Please provide a brand name and wet or dry.

How much do you feed your dog?

How often do you feed your dog?

Would you recommend your dog be placed in a home with children?

If yes, what ages?

Would you recommend your dog be placed in a home with other animals?

If yes, please check all that apply:

Has your dog ever lived with other animals?

If yes, please check all that apply:

Has your dog ever shown any aggressive, dominant, or fearful behaviors towards other animals? (dogs, cats, wildlife, etc.)

Does your dog have any fears?

If yes, please check all that apply:

What does your dog do when scared?

Does your dog have any behaviors for a new home to work on?

If yes, please check all that apply:

Other behaviors to work on:

When does your dog exhibit these behaviors?

How many hours is your dog comfortable being alone?

What are your dog's favorite toys and/or activities?

Please list any additional information you would like to share about your dog.

Please upload all vet paperwork here:

Please upload photos here:

Please upload videos here: