Russ Hollier Dog Training Behavioral Questionnaire
Please review this questionnaire first, then go back, and answer the questions as thoroughly as possible. If there was an incident (such as a bit), if possible, please ask those who were present for input as well.
What is the main issue you are concerned about? (Check All That Apply)
Aggression toward unfamiliar dogs
Aggression toward family member(s)
Aggression toward visitors
Aggression when handled/picked up
Aggression toward another dog or pet in the home
Aggression toward unfamiliar people in public
Aggression toward vet/groomer/pet sitter/dog walker
Other (please specify)
When did this behavior begin? (approximate date or how long ago)
Please check off any of the following that coincided with the change in your dog's behavior.
Person moving out of home
Pet in home dying/lost/rehomed
Environmental change (e.g. construction in home)
Use of physical corrections
New person/baby in home
Change in owner's work hours
Put on new medication
Moved to new location
Sent dog away for training
New pet in home
Change in amount of exercise
Change in diet/new treats
Less time to spend with dog
Please provide a general description of the issue including as much specific information as possible.
What, if anything, has been done to address the issue so far?
If steps have been taken to address the issue, did your dog's behavior improve, worsen or stay the same
Stayed the same
Became somewhat worse
Became much worse
If your dog has threatened or bitten another dog, please check all that apply.
Growls, lunges and/or barks at other dogs on walks
Growls, lunges and/or barks at other dog in home
Bit another dog while your dog was off leash
Bit another dog , drew blood (for example, torn ear)
bit another dog, inflicted multiple puncture wounds
Has air-snapped at another dog (no contact)
Bit another dog while your dog was on leash
Play between dogs at home escalates into fights
Bit another dog, inflicted puncture wound
Tried to kill another dog (e.g. "grab and shake"
If your dog has threatened or bitten a person, please check all that apply
Threatened (for example, growled, barked, air-snapped, lunged at) family member but no bite
Threatened (for example, growled, barked, air-snapped, lunged at) stranger in public but no bite
Threatened (for example, growled, barked, air-snapped, lunged at) visitor in home but no bite
Bit family member, no broken skin
Bit family member, single puncture wound
Bit stranger in public, no broken skin
Bit stranger in public single puncture wound
Bit visitor, no broken skin
Bit visitor, single puncture
Bit family member, broke skin (tear)
Bit family member, multiple puncture wounds
Bit stranger in public, broke skin (tear)
Bit stranger in public, multiple puncture wounds
Bit visitor, broke skin (tear)
Bit visitor, multiple puncture wounds
Bit vet or vet tech
Which of the following best describes your feelings about your dog's behavioral issue?
The problem is not serious, but I am curious about what you would suggest.
I would like to change the problem but it is not serious.
The problem is somewhat serious. I would like to change it, but if it remains unchanged we will live with it.
The problem is very serious. I would like to change it, but if it remains unchanged I will keep my dog.
The problem is extremely serious. I would like to change it. If it remains unchanged I will give my dog up or have him euthanized.
Is there anything else you feel we should know?
Do Not Fill This Out