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  • Please fill out the following as accurately as possible. This questionnaire is for both dogs and cats so some questions may not apply to your situation. Refrain from labeling your pet's behavior and instead make objective observations. (Example: rather than stating "My dog has separation anxiety," write "My dog chews on furniture when I leave, urinates in the crate and barks for hours." This will help us determine what is going on with your pet. Please be aware that we may ask you to take your pet to see your veterinarian. Many behavior issues are a result of underlying medical conditions and can be remedied with the appropriate treatment.
  • Your Pet's Medical History

  • Please provide dates for your pet's most recent vaccinations, if applicable. Vaccinations listed are for either dogs or cats.
  • Your Pet's Background Information

  • Your Pet's Home Environment

  • Management and Routine:

  • Behavioral Details:

  • Please answer the following questions if your pet has bitten a person.

  • Please answer the following questions if your cat is exhibiting inappropriate elimination or urine marking.

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