Canine Behavior Questionnaire Behavior Questionnaire: Canine Behavior Questionnaire: Canine Please return this questionnaire to us at least 7 days prior to your appointment date. This allows us time to review your dog's case, and come up with a treatment plan specifically for them. If we do not receive the questionnaire in that timeframe, we will need to reschedule your appointment. Please fill out this questionnaire to the best of your ability. If an answer is not known, please write in “unknown”. Answer all questions included in the packet, unless it states to skip a section due to your previous answer. Even if you think the question might not pertain to your dog's case, it can provide us with very valuable information to help us make a treatment plan for your dog. If you need to you can attach extra sheets of paper with a detailed response if you need more room for your answer (we love details!) please write the question at the top of the paper so we can easily see which question your response goes to. There is no such thing as too much detail when it comes to behavior, and if you have any videos or photos please forward them to us, or show me at your appointment. General Information Name * Name First First Last Last Address * Address Address Address City City State/Province State/Province Zip/Postal Zip/Postal Email * Phone * Secondary Phone Do you or anyone in your family have any food allergies? Yes No If Yes, Please List : If you are human, leave this field blank. Next
