Separation Anxiety Your Name * First Name Last Name Dogs Name How old was your dog when you first got them? Is your dog neutered and if so at what age? Briefly describe your dogs rough daily routine, such as how long they are left alone, what they are fed & how often, walks, any games you play with them, etc. Who lives in your house? Do you have any other pets? How is your dogs health? Are there any on-going or new issues? Does your dog allow you to handle them? Please provide details of any handing issues. How would you describe your dogs temperament/ character in general? Please describe the problem briefly, in your own words. How long has this been a problem for? And did anything in particular prompt the behaviour initially? How often is this a problem? How long can your dog be left before they exhibit anxious behaviours What does your dog do when they are left alone? (barking, crying, pacing, destructive behaviour, etc.) Where does your dog sleep at night time, and are they ok at night time? Please describe the most serious incident of this behaviour. What, if anything, have you already done to address the problem and what was the impact? Does your dog guard objects or food (possession aggression)? If so, please give details. Does your dog have any other fears/ anxieties? If there are other issues you wish to address please detail them here (such as toileting issues, aggressive behaviour, humping, annoying behaviour, etc.) If there is anything else you would like to add, please say here. Thank you, I will review this before our session. If you have any questions, please get in touch.Claire
