K.I.S.S. Dog Training - Mike & Dogs
K.I.S.S. Dog Training - Mike & Dogs

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Aggressive Dog Questionnaire

This questionnaire provides us with information about how your dog behavedĀ in many different circumstances while he or she was living with you. Because your dog is likely to behave in similar ways in his new home, this information will help us find the most suitable home for your dog and to effectively counsel the new family. Your open and honest answers are necessary and appreciated, so that we can create thoughtful and successful adoptions.

Dog & Household Info


Sex:

(years & months)


(years & months)

Is the dog spayed or neutered?

Your relationship to dog?


Including yourself, how many people of the following ages live in your house?

Age range
(years)
Female
Male
0-3
4-9
10-17
18-29
30-59
60+

What other animals does your dog live with?


Typical Behavior

How does your dog usually behave toward the following?

Never
encounter
Friendly
Afraid
Shows teeth
growls
Snaps
Bites
None of these
People your dog knows
Men
Women
Children
Unfamiliar people
Men
Women
Children
Animals your dog knows
Dogs
Cats
Unfamiliar animals
Dogs
Cats

 

Does your dog usually uncontrollably chase or attempt to chase any of the following?

 

How does your dog usually react when you or another family member does the following?

 
Never
tried
Enjoys
Allows
Afraid
Shows teeth
growls
Snaps
Bites
None of these
Bathe
Brush
Wipe Feet

 

How does your dog usually react when an unfamiliar person approaches or enters the yard or house?


Do you take your dog out to go the bathroom?




Does your dog usually have "accidents" in the house?





Where does your dog spend most of his/her time?



How long is your dog left alone, without people, during the week?



When your dog is left alone, is he/she...


When left alone, does your dog usually show any of the following behaviors?


When you are home, does your dog usually show any of the following behaviors?


When your dog plays, does he/she typically...
Bites hard


What toys does your dog like?


What games does your dog like?


Is your dog scared of anything?







Is your dog allowed on furniture?


Where does your dog usually sleep overnight?


What commands does your dog know?


Has your dog attended any obedience training classes?


Has your dog ever been walked on the leash?


Does your dog have problems riding in the car?



Has your dog escaped your property 2 or more times in the last 6 months?




Aggressive Behavior

Is there any report of your dog ever inflicting a serious bite to a person (such as an attack or a bite requiring hospitalization)?


Has your dog ever attacked another dog resulting in severe injury or death to another dog?


Has your dog ever attacked another domesticated animal species (cats or livestock but not "small pets" like hamsters, guinea pigs, etc.) resulting in severe injury or death to another domesticated animal?


Please check the appropriate box if your dog has ever shown any of the following aggressive behaviors toward men, women, children, dog, or another domesticated animal species (cats or livestock, not "small pets" like hamsters, guinea pigs, etc.) Do not include aggressive behaviors directed toward a veterinarian or groomer.

 
Shows teeth
growls
Snap
Bite
None of these
Don't know
Men
Women
Children
Dog
Other domesticated animal species (cat, livestock, etc.)


If a snap or bite to men or women was checked, did the snap or bite to adult take place while breaking up a dog fight or while a dog was in severe pain?


If snap or bite to children was checked, did the snap or bite to a child take place while breaking up a dog fight or while dog was in severe pain?




If any aggressive behavior to men, women, or children was checked in the table above, please answer the following questions. If does not apply, skip the table.

 
Men
Women
Children
 
Yes
No
Yes
No
Yes
No
Was the aggressive behavior over food?
Was it over bones or rawhides or chews?
Was it over toys?
Was it over stolen objects?
Was it when the dog was disturbed while sleeping or resting?
Was it when an adult or child handled the dog (brushing, handling feet, bathing, teeth brushing, ear cleaning, etc. but do NOT include reaction to vet or groomer)?
Was it when an adult or child entered the house or yard?
Was it when an adult or child approached or reached toward dog?

Medical History

Does your dog see a veterinarian at least once a year?


If yes, please specify the veterinarian's name and contact info:


Check if your dog has ever shown any of the following aggressive behaviors when handled by a veterinarian or groomer.

 
Never done
Show teeth
growl
Snap
Bite
None of these
Examine (including heart & ears)
Restrain
Administer shots
Trim nails
Take blood


Does your dog have to be muzzled at the veterinarian?


Does your dog have any past or present medical conditions?



Is your dog currently on any medication or special diet?



What type of food does your dog eat?





Certify Information

By signing below, I certify that the information I provided is accurate and truthful to the best of my knowledge.

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