Match-Up II Manual - Center for Shelter Dogs

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Match-Up II Shelter Dog Rehoming Program Appendix C: Behavioral Triage Worksheet
Behavioral Triage Dog’s Name: ___________________________ ID#____________ M N F S Breed: ______________________ Age: ____________ TOTAL TRIAGE POINTS: SECTION 1: BEHAVIORAL HISTORY refer to Intake History A. NO INTAKE HISTORY AVAILABLE (Check box) Check box on the right, if no intake history and skip to Section 2. Add 3 pts to Section 1 Behavioral History Total. +3 B. AGGRESSION (Check box) 1. Attack or uninhibited bite resulting in severe injury to a person (such as a bite that requires stitches or multiple bites even if no medical care is required) +50 2. To Adults – Check all that apply, then circle and add only the highest points to Section 1 Behavioral History Total. (Check box) A. Show teeth, growl – Adults Men Women B. Snap – Adults Men Women C. Bite – Adults Men Women Note: If snap or bite to an adult at Items 2B or 2C was while breaking up a dog fight or if the dog was in severe pain, SUBTRACT 7 points from the points received for the snap or bite (do not subtract points if only show teeth/growl). +6 +8 +12 –7 If any aggression to adults in Sub-Section 2, answer the following questions but don't add any points (target is always an adult): 2.1. Was it over food? 2.2. Was it over bones, rawhides, or chews? 2.3. Was it over toys? 2.4. Was it over stolen objects? 2.5. Was it when the dog was disturbed while sleeping or resting? 2.6. Was it when a person handled the dog (brushing, handling feet, bathing, teeth brushing, ear cleaning, etc. but do NOT include reaction to vet or groomer)? 2.7. Was it when a person entered the house or yard? 2.8. Was it when a person approached or reached toward the dog? 3. To Children – Check all that apply but add only the highest points to Section 1 Behavioral History Total. A. Show teeth, growl – Children B. Snap – Children C. Bite – Children Note: If snap or bite to a child at items 3B or 3C was while breaking up a dog fight or if the dog was in severe pain, SUBTRACT 7 points from the points received for the snap or bite (do not subtract points if only show teeth/growl). Yes Yes Yes Yes Yes Yes Yes Yes (Check box) No No No No No No No No +8 +10 +14 –7 Dog’s Name: ___________________________ ID#____________ Date_________________ Behavioral Triage Points Form 1 of 9
Page 1 and 2: Match-Up II Shelter Dog Rehoming Pr
Page 5 and 6: Match-Up II Behavior Evaluation Get
Page 7 and 8: Match-Up II Behavior Evaluation Bef
Page 9 and 10: Sub-Test 6: Run and Freeze Handler
Page 11 and 12: Match-Up II Personality Scoring Cal
Page 13 and 14: Match-Up II Behavioral Triage
Page 15 and 16: Match-Up II Behavior Evaluation Def
Page 19 and 20: Dog Name:__________________________
Page 21 and 22: Dog Name:__________________________
Page 23 and 24: Dog Name:__________________________
Page 25: Dog Name:__________________________
Page 29 and 30: SECTION 2: BEHAVIORAL EVALUATION re
Page 31 and 32: SUB-TEST 10 - STRANGE-LOOKING WOMAN
Page 33 and 34: 4. To Vet/Groomer - Check all that
Page 35: Triage Point Range Descriptions 0-3

Match-Up II Manual - Center for Shelter Dogs

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