Client Forms: Dog Behavior Consultation Form Find an Embassy Location Client Forms: Dog Behavior Consultation Form Find an Embassy Location Dog Behavior Consultation Client Information Location * - Select One -Hardin ValleyEmory RoadLenoir CityWestland DriveLand O'Lakes Name * Name First Name First Name Last Name Last Name Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Phone * Email * Emergency Contact * Emergency Contact First Name First Name Last Name Last Name Patient Information Pet Name * Breed * Current Weight * Age * Sex * Species * Neutered/Spayed * Yes No Chronic Health Conditions Personality Typical Daily Routine Feeding Schedule Exercise/Enrichment Elimination Behaviors Social Interactions Household Setup and Dynamic People in the Household Names, Ages, Occupations, Hours Away Other Pets in the Household(Names, Ages, Species/Breeds) Type of Home Size (Apartment/House)), Yard (Fenced/Unfenced) Activity Level High Moderate Low Degree of Predictability in Routine Predictable Unpredictable Patient's Early History Birth and Early Environment Age and Process of Acquisition Source (Breeder/Shelter/Other) Integration into the Home Early Socialization Process Patient’s Learning History Training Styles Used Response to Training Ease of Learning Easy Moderate Difficult Skills/Behaviors Learned Use of Professional Trainers or Behaviorists Names, Techniques Used Training Equipment Used (Past and Present):Leash, Crate, Harness, Collars, etc. Common Anxieties, Fears, and Displays of Aggression Behavior When Family Prepares to Leave: Signs of Separation Anxiety (Destruction, Vocalization, Elimination, Vomiting) Aggression in Social Situations: Frequent Visitors, Occasional Visitors, Unknown People, Dogs Aggression Triggers (Specific Situations Reaction to Loud Noises (Thunderstorms, Fireworks) Aggression Toward People: When Handled, Groomed, Petted, Resting Aggression Triggers (Primary Owner, Other People, Children, Co-owners Targeted Behavior Information Age and Scenario of First Incident Progression of Behavior Over Time: (Worsened, Improved, Unchanged) Frequency of Undesired Behavior: (Daily, Weekly, etc.) Severity of Safety Risk (Using Dog Bite Scale) Recovery Period After Incident Common Environmental Triggers: (Location, Other Animals, People Present) Techniques Used to Address Behavior (Success or Failure) Welfare Assessment Impact of Behavior on Client’s Welfare Physical and Emotional Stress on Client Risk of Rehoming, Abandonment, or Euthanasia Client’s Goals and Perception of the Problem Submit If you are human, leave this field blank.