CANINE BEHAVIOR CONSULTATION QUESTIONNAIRE CANINE BEHAVIOR CONSULTATION QUESTIONNAIRE Please fill out this questionnaire for each dog. PET BEHAVIOR QUESTIONNAIRE - PHOENIX DOG TRAINING Please fill out all areas of this form. The more complete the questionnaire, the better we can assess and help your pet. GENERAL INFORMATIONName* First Last Email* Phone*Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Have you already spoken to someone from Phoenix Dog Training* Yes No I'm Not Sure Before Filling Out This Form, I Previously Spoke with ______ From Phoenix Dog Training* Does Not Apply Brittany Jordan Will I'm Not Sure? Referred by (trainer, friend, veterinarian, other) Veterinarian / Clinic Veterinarian Phone NumberVeterinarian Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Upload Copy of Medical Records, (Lab reports for blood work) if PossibleMax. file size: 128 MB.PET INFORMATION (Click the + to add additional Pets/Rows)Click + For Additional Rows For More Than One PetPet's NameBreedColorAgeWeightSex Click + For Additional Rows For More Than One PetClick + For Additional Rows For More Than One PetPet's NameAge ObtainedWhere Did You Get This Pet?Breeder, if ApplicableBehavior of Litter-mates? Click + For Additional Rows For More Than One PetClick + For Additional Rows For More Than One PetPet's NameNeutered/Spayed?Age Neutered?Any Change After Neutering? Click + For Additional Rows For More Than One PetREASON(S) FOR CONSULTATIONPlease List Behavior Problems in Order of Importance and Score The Severity. 10 is Most Severe, 1 is Least Severe*Pet's NameProblemFrequency (Score Severity 1-10)Intensity (Score Severity 1-10)Duration of Behavior Each Episode (Score Severity 1-10)Onset - When Did Problem Start? Click the + For Additional Rows For More Than One Problem And More Than One Pet INFORMATION ON PRESENTING PROBLEMSWhat Do You Think Has Caused The Problem(s)?:Put Pet's Name Then Cause(s)Describe The Problem - Last Incident: (Make Sure to Include Such Descriptions (If Possible) of The Dog's Body Posture, Locations of Other People or Animals in The Vicinity, Circumstances That You Believe Stimulated The problem, Etc)Describe Previous Incidents:Has There Been a Recent Change in The Frequency of the Behavior?What Has Been Done So Far to Try and Correct The Problem?What Has Been the Dog's Response?List Any Techniques That Have Been Successful:List Any Techniques That Have Made The Problem Worse:List Any Medications That Have Been Used To Help The Problem So Far And The Dog's Response To The Medication:Pet's NameMedicationMg. StrengthFrequency (e.g. once a day, twice a day)How Long on Medication (e.g. days, weeks, months)Outcome (e.g. did the medication help yes/no?If Yes (what % improvement) Click + For Additional Rows For More Than One MedicationDoes Your Pet Have Any Allergies to (Medications, Foods, Environmental e.g. Grass, Pollen,) List All Allergies Including Names Of Any Medications and Your Pets Allergic Reaction:List Any Other Supplements, Remedies, Dietary Treatments, And The Dog's Response:FAMILY RELATIONSHIPSList Each Family Member Living In The Home With The Pet (Include Sex And Age)First NameLast NameSexAge Click + For Additional Rows To Add Addition Family MembersHow Does Your Dog Get Along With Each Family Member?Who Feeds And What is The Feeding Schedule?Who Gives Treats? (How Often, Amount, and Type of Treats)Who Plays And What Type Of Play? (List and Favorite Toys Also)Who Grooms And How Does Your Pet Tolerate Grooming? (Excellent, Good, Fair, Poor) List What Grooming Entails e.g. (Bathing, Brushing, Nail Trimming, Ear Cleaning, Clipping, Drying By Towel or Blow Dryer)Who Trains? (What Does That Consist Of And How Often)Who Exercises/Walks? (List Type of Exercise, How Often And For How Long Of Time)Briefly Describe The Family Schedule, Including How Long The Dog Is Left Alone. (Include Where Your Dog Is Left When Along e.g. Outside, Crate, Laundry Room, Bed Room, Kitchen, Complete Access Of The House)List The Pets In Your HouseholdPet's NameSpeciesBreedSex (Spayed/Neutered?)Age ObtainedAge Now Click + For Additional Rows To Add More PetsHow Do The Pets Get Along With Each Other?Have Any Family Members or Pets Moved, Been Recently Re-Homed, Or Passes Away, And How Has That Affected Your Pet?TRAININGHas There Been Any Formal Training? YES NO If There Has Been Any Formal Training, What Type?Please Check All That Apply Group Class Board And Train Private Lessons Away From Home Private Lessons At Home If There Was Training, What Company Was The Training With and the Name of Your Past Trainer(s). How Successful Was Training? What Did The Training Consist Of? What Command Were Taught? What Behavior Problems Were Worked On?What Type Of Training Collar Was UsedPlease Check All That Apply Flat Collar Remote Collar (Electric) Remote Collar (Vibration) Remote Collar (Tone) Remote Collar (Citronella Spray) Choke Collar Prong/Pinch Collar Head Halter (e.g. Gentle Leader, Halti Body Harness Describe Your Dog's Response To Any Training Tools Used:How Would You Describe The Training Method?Please Check All That Apply Reward-Based Mostly Aversive/Corrections Balanced Training (Rewards and Corrections) Assertive/Dominance Other If You Selected Other Please describe (Use This Space For Any Additional Comments About Previous Training Methods.)How Well Does Your Dog Obey The Following Commands (When Asked The FIRST Time And When DISTRACTED) For Each Household Member? (List as a Percent)Household MemberSit %Down %Stay %Come %No % Click + To Add Rows For Additional Household MembersAre There Any Other Commands Or Tricks Your Dog Knows And How Reliable Are They The FIRST Time You Ask And When DISTRACTED? (List As a Percent)PUNISHMENTHave You Ever Used Any Og The Following For Punishment Or Training?Please Check All That Apply Physical Punishment Noise Punishment (Shaker Can, Compressed Air, Other Noise) Ultrasonic Sound (e.g. Petagree) Water Sprayer Verbal Reprimands Physical Handling (Alpha Rolls, Pinning, Muzzle Grasp) Time Out ScatMat (Shock) Booby Traps/Repellents Bark Collar (Electric) Bark Collar (Vibration) Bark Collar (Tone) Bark Collar (Spray (Citronella) Please Describe Your Dogs Response To Any Types Of Punishment You May Have Checked Above:HANDLINGDoes Your Dog React Negatively To Any Of The Following Types Of Handling (Please Check All That Apply)Please Check All That Apply Nail Trimming Brushing Bathing Rubbing Belly Grabbing Collar or Neck Rolling Over Giving Pills Hugging/Kissing Patting/Petting Head Lifting For Anything You May Have Checked Above, Please Describe Your Dog's Response. Also List Any Touch Sensitivities Your Dog May Have Not Listed.MEDICAL SCREENAre There Any Past Or Present Illnesses, Injuries, Surgeries? If So, Please List Along With Dates:Does Your Dog Have Any Painful Conditions (Yes/No, Please Describe)What Kind Of Diet Is Your Dog On?Please Check All That Apply Dry Canned Raw Dehydrated Home Cooked Describe Your Dog's Appetite:Please Check All That Apply Voracious Normal Finicky Decreased Increased Same Any Change In Drinking? More Less Same Describe Your Dog's Weight:Please Check All That Apply Ideal Underweight Overweight Recent Weight Gain Recent Weight Loss Any Changes In Stool?Please Check All That Apply Yes No Increased Decreased Softer/Loose Firmer/Constipated Varies Often From Loose To Firm Any Change In Urination?Please Check All That Apply Same More Frequent Less Frequent Larger Volumes Smaller Volumes Any Food Intolerances?Please Check All That Apply Yes No If You Answered Yes To Food Intolerances, Please List Foods And Describe Reactions:Is Your Pet On Any Medications? (Besides The Medications Listed Under Primary Behavior Complaint)Pet's NameMedication Name:Dosage:Frequency Given (times per day)Duration Of Medication (how long taken) Click + To Add Addition Rows Of MedicationsIs Your Pet On Any Supplements? (Besides The Supplements Listed Under Primary Behavior Complaint)Pet's NameSupplement Name:Dosage:Frequency Given (times per day)Duration Of Supplement (how long taken) Please Click + To Add Additional Rows Of Supplements REINFORCER ASSESSMENTIf Your Dog Were Allowed To Have ANY Treat, What Would He/She Prefer? List Top 5Pet's Name1.2.3.4.5. What Other Types Of Rewards Does Your Dog Enjoy? (Play, Toys, Attention/Affection, Walks) List Top 5Pet's Name1.2.3.4.5. HOUSE-TRAINING SCREEN (If Your Pet Is Not House-soiling, Skip This Section)Was Your Dog Ever Completely House-Trained? Yes No At What Age Was He/She Considered House-Trained? How Often Does Your Dog House-Soil? (ie. Several Times a Day, Weekly, Monthly?) Is It Urine, Stool Or Both? When Is Your Dog Most Likely To House-Soil? Do You Have A Doggie Door? Yes No Had In The Past For This Dog Does Your Dog Use The Doggie Door? Yes No Sometimes In What Rooms/Locations Does Your Dog Tend To House-Soil? Are There A Rooms/Locations In Which Your Dog Does NOT Soil? (Please List) Does Your Dog House-Soil When Family Members Are Home? Yes No Does Your Dog House-Soil Directly In Front Of A Family Member? Yes No What Do You Do When You Find Urine Or Stool In A Improper Location? Does Your Dog Urine Mark? (Urinate On Upright Objects) Yes No How Many Times A Day Does Your Dog Have A Chance To Go Outside To Eliminate? How Long Is The Longest Confinement Without Access To Outside (If Any)? Is Your Dog Ever Crated? Yes No Is There Ever Urine/Stool In The Crate? Yes (Urine) Yes (Stool) Yes (Both) No Does Your Dog Leak Urine When: (Check All That Apply) Sleeping Walking Approached By Owner Approached By Stranger Excited Frightened DEPARTURE BEHAVIOR SCREENHow Long Is Your Dog Left Alone On An Average Day? Is Your Dog Left? Indoors Outdoors Access To Both Is Your Dog Crated Or Confined On Departure? Yes No If Crated Describe Type Of Crate And Location Of Crate: If Confined Other Than Crate Describe: Has Your Dog Been Left At A Kennel, Veterinary Clinic Or With Family Or Friends? Yes No If Yes, Describe Your Dog's Reaction: Does Your Dog Exhibit Any Problem Behaviors On Your Departure? Yes No If Your Dog Exhibits Any Problem Behaviors On Your Departure Please Describe Your Dog's Behavior When Left Alone:Does he Behavior Differ Depending On The Length Of Departure Or The Time Of Day Left Alone? Yes No How Does Your Dog Act As You Or Other Family Members Are Ready To Leave? Describe:Does The Behavior Differ Depending On Who Is The Last To Leave The Home? Yes No How Does Your Dog React When You Or A Family Member Returns Home? Describe:Have You Ever Left Your Dog Alone In A Car? If So, How Did, He/She React?AGGRESSION SCREENHas Your Dog Displayed Any Of The Following? (Check All That Apply) Select All Threatening Behavior Growling Bite Attempts Bites Situations That Led To Aggression (Answer All That Apply)Petting/Handling Growled Attempted To Bite Bitten No Reaction Describe:Eating Or Being Approached While Eating Growled Attempted To Bite Bitten No Reaction Describe:Chewing Stolen Objects/Toys, Attempting To Take Away From Dog Growled Attempted To Bite Bitten No Reaction Describe:Trimming Nails/Bathing/Brushing Growled Attempted To Bite Bitten No Reaction UntitledStaring At Dog Growled Attempted To Bite Bitten No Reaction Describe:Scolding Dog Growled Attempted To Bite Bitten No Reaction Describe:Lash Or Collar Correction Growled Attempted To Bite Bitten No Reaction Describe:Physically Reprimanding Dog Growled Attempted To Bite Bitten No Reaction Describe:Raising Hand Over Dog Growled Attempted To Bite Bitten No Reaction Describe:Bend Or Lean Over Dog Growled Attempted To Bite Bitten No Reaction Describe:Hug Or Kiss Dog Growled Attempted To Bite Bitten No Reaction Describe:Grabbing Collar Growled Attempted To Bite Bitten No Reaction Describe:RollingYour Dog Over Growled Attempted To Bite Bitten No Reaction Describe:Disturbing While Sleeping Growled Attempted To Bite Bitten No Reaction Describe:While Dog Is On Furniture/Bed Attempting To Remove Dog Growled Attempted To Bite Bitten No Reaction Describe:AGGRESSION TOWARDS PEOPLE (If your Dog Is Not Aggressive Towards People, Skip This Section And Move To The Next)In Your Opinion, What IS The Potential For Injury To Another Person? Describe:Has Your Dog Ever Bitten Hard Enough To Break Skin Or Cause Injury? Yes No If You Answered Yes, Describe:Number Of Bites That Have Broken Skin: Total Number Of Bites Body Parts Typically Bitten And Severity. Describe:If Your Dog Has Bitten A Person, How Old Was The Dog When He/She First Bit: Has Your Dog Ever Been Aggressive Towards Members Of The Immediate Family? Yes No If You Answered Yes ToThe Above Question, To Whom Was Your Dog Aggression And Describe The Incident(s)Is Your Dog Ever Aggressive Towards Strangers? Yes No If You Answered Yes ToThe Above Question, To Whom Was Your Dog Aggression And Describe The Incident(s)Is Your og Aggressive Towards People Off Property? Yes No If You Answered Yes ToThe Above Question, To Whom Was Your Dog Aggression And Describe The Incident(s)Is There A Particular Person Or Type (Age, Sex, Build, Uniforms, Clothing Or Apparel) That Your Dog Is Most Likely To Threaten Or Bite? Describe:Is There A articular Location Or Situation Where Aggression Is Most Likely To Occur? Describe:What Is The Usual Distance Away From A Person When Attempting To Attack? Describe:When Your Dog Threatens, Attempts To Bite, Or Bites, How Do You Handle The Situation And What Is The Dogs Reaction? Describe:How Would You Describe Your Dog's Attitude At The Time Of Aggression? (Bold, Protective, Fearful, etc)How Would You Describe Your Dog's Expression And Postures At The Time Of Aggression? (Hackles Raised, Ears Forward or Ears Back, Tail Up, Tail Down Or Tucked Between Legs and Under, Cowering, Running Forward, Running Forward And Then Retreating) Describe:Aggression Towards People (Check All That Apply) Tries To Attack From A Distance Investigates The Person Before Attacking Barks/Growls Before Attacking Does Not Bark Or Growl Before Attacking Bites Once And Retreats Bites Multiple Times And Retreats Bites And Does Not Let Go AGGRESSION TOWARDS DOGS (If Your Dog Is Not Aggressive Towards Dogs, Skip This Section And Move To The Next)In Your Opinion, What IS The Potential For Injury To Another Dog? Describe:How Old Was Your Dog When You First Noticed Aggression Towards Other Dog(s): Has Your DogEver Bitten Hard Enough To Break Skin Or Cause Injury To Another Dog Requiring Medical Attention? Yes No Number Of Bites That Have Broken Skin: Total Number Of Bites: Body Parts Typically Bitten And Severity. Describe:Is There A Particular Location Or Situation Where Aggression Is Most Likely To Occur? Describe:What Is The Usual Distance Away From Another Dog When Attempting To Attack? Describe:Aggression Towards Other Dogs (Check All That Apply) Tries To Attack From A Distance Investigates The Other Dog Before Attacking Barks/Growls Before Attacking Does Not Bark Or Growl Before Attacking Attacks Only Bigger Dogs Attacks Only Smaller Dogs Size Of Dog Does Not Matter Attacks Only Female Dogs Attacks Only Male Dogs Gender Of Dog Does Not Matter Bites Once And Retreats Bites Multiple Times And Retreats Bites And Does Not Let Go ANXIETY/PHOBIA/FEAR/ SCREENDoes Your Dog Experience Separation Anxiety When You Leave? Yes No If You Answered Yes, Describe Your Dogs Reaction:On A Scale Of 1 to 10, 10 Being The Most Severe, 1 Being The Least Severe, How Would You Score Your Dogs Separation Anxiety? List Other Triggers That Cause Your Dog Anxiety/Phobia/Fear (People, Dogs, Cars, Children, Thunderstorms, Loud Noises, Stairs, Vacuum Cleaners, Grooming, Certain Objects, etc)Pet's NameTriggerFrequency (Daily, Weekly, Monthly etc.)Intensity Score (1-10) 10 Is Most SevereDuration (How Long Is The Anxiety Attack)Onset - When Did Problem Start? (How Long Ago) Click + To Add Additional Rows For Additional TriggersFor Each Trigger List Your Dogs Reaction (Runs, Hides, Trembles, Drools, Pants, Paces etc.)ADDITIONAL BEHAVIOR PROBLEMSCheck All Behaviors That Apply To Your Dog Destructive Chewing Barking Whining House-Soiling (Urine) House-Soiling (Stool) Stool Eating Hunting / Predation Jumps Up (Owners) Jumps Up (Guests) Garbage Raiding Food Stealing Counter Surfing Stealing Personal Items Hoarding Items Pushy -Wants Its Own Way Only Listens When Feels Like It Masturbation Mounting/Humping Urine Marking Fence Jumping Door Dashing Runs Away Roaming To Mate With Other Dog Obsessively Chews/Licks Self Obsessive Licking Of People Obsessive Licking Of Toy, Objects, Furniture Obsessive Wool Suckling (Blankets, Sheets, Cloth) Uses Toys or Objects As A Pacifier Eats Non Food Items (Pica) Tail Biting Tail Chasing Walks is Small Circles Walks in Large Circles Paces Excitability Overactivity Imaginary Fly Chasing Staring At / Chasing Imaginary Objects Uncontrollable Urination When Excited Uncontrollable Urination When Frightened Bedwetting While Sleeping Phobias Shyness / Timidity (Nonaggressive) Additional Problems Not Listed If You Checked Off Additional Problems No Listed, Please List And Describe:Please Write Any Additional Comments That You Think Would Be Helpful In Understanding Your Dog And His/Her Behavior:What Are Your Goals And Objectives In Having Us Help You With Your Pet. Please List In Order Of Importance:
