Behavior History Form

Behavior History Form

Help us develop the most effective plan for you and your dog by providing complete and thorough answers on this Behavior History form. There are no right or wrong answers.

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of Additional Contact(Required)

Additional Contact Phone/Email(Required)

DOG INFORMATION

Dog's Name(Required)

Gender:(Required)

Male

Female

Is your dog spayed/neutered?(Required)

Yes

Age(Required)

Weight(Required)

Breed(Required)

Have you done a DNA test?(Required)

Yes

When did the dog come to live with you?(Required)

HOUSEHOLD INFORMATION

Check all age groups represented by the people residing in, or spending a significant amount of time, in your household.

What other types of animals are part of your family? (Check all that apply)(Required)

MEDICAL & HEALTH INFORMATION

Veterinarian Contact Information:(Required)

Clinic & Veterinarian Street Address City State Phone

Date of your dog's last veterinary exam:(Required)

Do you give Crimson Hound permission to discuss your dog's case with your veterinarian, if necessary?(Required)

Yes

Proof of the following vaccinations is required: Rabies, Distemper, Hepatitis, Leptospirosis and Parvovirus (DHLP). Upload a copy of your dog's vaccination records here. If you are unable to do so, you can email a copy to training@crimsonhound.com or bring a copy to your FIRST training session.

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 128 MB.

Vaccination requirement is age specific. Puppies should be vaccinated as is age appropriate. Titer results are accepted.

BEHAVIOR INFORMATION

List the behaviors that prompted you to contact Crimson Hound.(Required)

Is anyone in your household afraid of this dog?(Required)

Yes

Not sure

Are you or another adult in the household able to physically control this dog?(Required)

Yes

Not sure

Check all of the behaviors that describe your dog's reaction to each of the following scenarios: HANDLING/GROOMING:(Required)

STRANGE VISITORS:(Required)

FAMILIAR VISITORS:(Required)

FAMILIAR DOGS - YOUR HOME/YARD:(Required)

STRANGE DOGS - YOUR HOME/YARD:(Required)

PEOPLE - OUT ON A WALK:(Required)

DOGS - OUT ON A WALK:(Required)

MOVING OBJECTS (cars, bikes, joggers ...):(Required)

NEW/UNFAMILIAR OBJECTS:(Required)

VET VISITS:(Required)

CHILDREN:(Required)

Is your dog "protective" of any of the following:(Required)

How does your dog behave when you are preparing to leave the home?(Required)

No reaction

Paces

Whines/barks

Pants/drowls

Check any behaviors that your dog does when left alone:(Required)

Relaxed (sleeps; chews appropriately; etc.)

Whines/Barks/Howls

Paces or moves from room to room

Pants/Drools

Urinates/Defecates

Destroys household items (toys, shoes, etc.)

Destroys doors, window sills, walls, etc.

Has your dog snapped or lunged at or nipped/bitten a person? Describe each incident in detail - including how much damage was inflicted (e.g., no skin contact, scratch, stitches, etc.):(Required)

Fights with dogs inside or outside your household: Describe each incident in detail - including how much damage was inflicted (e.g., no damage, scratches, stitches, etc.):(Required)

Use this space to elaborate on any questions above or to add anything else that you would like me to know.

May I add your name to the Crimson Hound mailing list to receive training tips, new classes and workshop offerings?(Required)

Yes

How did you find Crimson Hound dog training?(Required)

Name

This field is for validation purposes and should be left unchanged.