BEHAVIOR MODIFICATION HISTORY FORM

Please fill out the following to the best of your ability. The more information you are able to give us that pertains to your dog, the better we will be able to help you.

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DOG INFORMATION (CONT.)

SELECT THE TYPE OF TRAINING YOUR DOG HAS HAD:

TRAINING HISTORY

HOW MANY ANIMALS WERE IN YOUR PET'S LITTER?

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ANY LITTERMATES AFFECTED WITH MEDICAL PROBLEMS?

ANY LITTERMATES AFFECTED WITH BEHAVIORAL PROBLEMS?

IF YES, WHAT SPECIFICALLY?

WHY DID YOU CHOOSE THIS SPECIFIC PUPPY FROM THE LITTER?

LITTER INFORMATION

WHY DID YOU CHOOSE THIS SPECIFIC BREED?

PET OWNERSHIP HISTORY

HAVE YOU OWNED THIS PARTICULAR BREED OR BREED CROSS BEFORE?

HAVE YOU OWNED PETS BEFORE?

HAVE YOU OWNED DOGS BEFORE?

HAVE YOU OWNED CATS BEFORE?

HAVE YOU OWNED BIRDS BEFORE?

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