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Behaviour Consult Enquiry
Complete the questions to help us identify the best program for you and your dog
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Your Name
*
Your answer
Suburb
*
Your answer
Email address
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Your answer
Phone Number
Your answer
Dog's Name, breed and age
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Your answer
How many people live in home? Are there children? If so, what are the child/ren's ages?
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Your answer
Does the dog have any medical conditions? Last time they saw the vet?
Your answer
Complaint / Problem 1
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Your answer
Rate Seriousness of Problem 1
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Very Serious
Serious
Not Serious
Complaint / Problem 2
Your answer
Rate Seriousness of Problem 2
Very Serious
Serious
Not Serious
Clear selection
Complaint / Problem 3
Your answer
Rate Seriousness of Problem 3
Very Serious
Serious
Not Serious
Clear selection
Please select any behaviours that your dog exhibits (aggression and fear related)
Resource Guarding
Handling aggression
Reactive to strangers
Aggression/intimidation of household members
Reactivity to other dogs when on lead
Reactivity to other dogs when off lead
Aggressive to cats
Barking
Destruction
House Soiling
Impulse control
Separation Anxiety
Movement Sensitivity / Prey Drive
Baby / Child Preparation
Bites to Humans
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No Bite History
Bared Teeth / Snarl / Growl
Snap (1)
Contact - no damage (2)
1-4 shallow punctures (3)
1-4 punctures/bruising (4)
Deep bi-lateral tears (5)
Multiple level 4-5 bites (6)
Other:
Bites to other dogs / animals
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No Bite History
Bared Teeth / Snarl / Growl
Snap (1)
Contact - no damage (2)
1-4 shallow punctures (3)
1-4 punctures/bruising (4)
Deep bi-lateral tears (5)
Multiple level 4-5 bites (6)
Mutilation or Fatality
Other:
How are you feeling while handling your dog in these senarios?
*
Confident, I just want to know what I should do
I get nervous and feel the dog feeds of my reactions
I'm ok, but need help to build my confidence further
I can no longer be involved in activities with my dog
Other:
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