San Diego Humane Society

Pet Guardianship Questionnaire: Dog

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Question - Required - Today's Date:




  YOUR INFORMATION

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Name:

 

 

 

     

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City/State/ZIP:

 

    

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YOUR DOG'S INFORMATION

 

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Question - Required - Dog's Gender:


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Question - Required - Where did you acquire this dog?











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Question - Required - Does your dog have a preference for:

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Question - Required - How would you describe this dog, in general?

 

 

BEHAVIOR INFORMATION

 

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Question - Required - How does this dog behave with ADULT members of the household? Select all that apply:

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Question - Required - How does this dog behave with CHILD members of the household? Select all that apply:

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Question - Required - How does this dog behave with ADULT visitors to the home?

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Question - Required - How does this dog behave with CHILD visitors to the home?

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Question - Required - How does this dog behave with ADULT strangers? Select all that apply:

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Question - Required - How does this dog behave with CHILD strangers? Select all that apply:

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Question - Required - What makes your dog anxious or worried, or causes it to behave in a different manner than usual?

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Question - Required - If this dog is kept in a fenced yard or run, how does it behave?

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Question - Required - When in a fenced yard or run, this dog is friendly with:

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Question - Required - When in a fenced yard or run, this dog is unfriendly with:

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Question - Required - Does your dog have any behaviors that you consider to be a problem, or that a future owner should be aware of?

 

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Question - Required - Describe your dog's play intensity:





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Question - Required - Activities you do with your dog:

 

 

HOUSING AND FEEDING INFORMATION

 

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Question - Required - This dog is an:



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Question - Required - Where is this dog when you are HOME?



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Question - Required - Where is this dog when you are OUT?



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Question - Required - In a 24-hour day, how long is this dog left alone at any given time?




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TRAINING INFORMATION

 

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Question - Required - When does this dog have accidents?

 
Question - Not Required - Accidents Are:



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Question - Required - Where does this dog go potty?

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Question - Required - How do you know when the dog needs to go out?

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Question - Required - What training equipment has this dog been exposed to?

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Question - Required - Which behaviors is this dog familiar with?

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Question - Required - Leash Walking Behavior:

 

 

VETERINARY INFORMATION

 

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ADDITIONAL INFORMATION

 

 

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