Canine Behavior Follow-Up Form | Dog and Puppy Training in Westport, CT

PART 1. BASIC INFORMATION

First Name

Last Name

Email Address *

Phone Number *

Dog’s Name *

Dog’s Sex *

Dog’s Current Age *

How would you currently describe the severity of the behavior problem?

What are your goals for this follow-up consultation? *

If applicable, please describe any changes in environment since our last consultation.

If applicable, please describe any management, training, or behavior modification measures you’ve implemented since our last consultation.

Describe the last incident in as much detail as possible. *

How many times has the problem occurred in the past week?

How many times has the problem occurred in the past month?

Since our last consultation, how many bites have there been resulting in broken skin or injury to humans or animals?

Who were the target of the bites?

Please list any updates to your dog’s medical status and/or behavioral medications.

Thank you for taking the time to fill out this form.