Transcription of CANINE BEHAVIOR CONSULTATION QUESTIONNAIRE
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CANINE BEHAVIOR CONSULTATION QUESTIONNAIRE
Landsberg G, Hunthausen W, Ackerman L 2003 Handbook of BEHAVIOR Problems of the Dog and Cat. Saunders, Edinburgh#2003, Elsevier Science Limited. All rights BEHAVIOR CONSULTATION QUESTIONNAIREGENERAL INFORMATIONName:Date of CONSULTATION :Address:Postal (zip) code:Email:Phone: Home: ()Business: ()Fax: ()For referred cases: Veterinarian s name & clinic:Clinic phone:Clinic address:How did you hear about our service?PET INFORMATIONPet s name:Date of birth:Weight:Sex: M/FNeutered: Y/NAge neutered:Any change after neutering?Breed:Color:Age obtained:Where did you obtain this pet?Breeder (if applicable):Describe previous home/homes (if known):For what purpose was your pet obtained? BEHAVIOR of parents or littermates (if known):Briefly describe your dog s personality ( , quiet, confident, excitable, unruly, bold, stubborn, etc.)THEHOMEENVIRONMENTType of food:How often is your pet fed?
Landsberg G, Hunthausen W, Ackerman L 2003 Handbook of Behavior Problems of the Dog and Cat. Saunders, Edinburgh # 2003, Elsevier Science Limited.
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