Behavioral Questionnaire for Dogs Behavioral Questionnaire for Dogs Behavioral Questionnaire for Dogs Client Name * Client Name First First Last Last Client Number * Email * Patient Name * Age * Breed * Spayed/Neutered? * Yes No HOME ENVIRONMENT Please list the people, including yourself, living in your household: Name Age Relationship to primary owner Occupation (optional) Average # of hours away from home Quality of relationship with patient plus1 Add another person minus1 Remove a person Please list all the animals in the household in the sequence they were obtained: Name Species & Breed Age when pet came into home Age now Quality of relationship with patient plus1 Add another animal minus1 Remove an animal If you are human, leave this field blank. Next
