Behavior Evaluation Questionnaire

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Please take a few minutes to answer the questions as accurately as possible. This form will guide you to answer only the questions applicable to your dog's behaviors - you will not necessarily need to answer every section. The form should take 5-10 minutes to complete. We appreciate your participation in helping us recommend and design the most effective treatment protocol!

Email *

Your Name *

Have you spoken or emailed with a member of the BtD staff prior to completing this form?

Yes, spoke on the phone

Yes, submitted email inquiry

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Dog's Name *

Dog's Age

Breed (or approx. weight/size if breed unknown)

Is your dog currently on any medication? If so, what type and for how long?

Have you completed an Assessment with Beyond the Dog? *

Yes

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