Behavioral Questionnaire - Professional Dog Training Sam Wike ...

For each specific incident, please provide the following information. (Copy this section on to another page ifyou need to provide information about more than one incident.)Date of incident __________________________Location of incident ________________________________Who was present? ____________________________________________________________________________What other dogs/animals were present? ___________________________________________________________Was your dog on leash? ☐ Yes ☐ NoIf so, who was holding the leash? ______________________________What preceded the incident? ____________________________________________________________________Had your dog been feeling well prior to the incident? _________________________________________________Did your dog give any warning signals? If so, what were they? _____________________________________________________________________________________________________________________________________If there was a bite:What was the location on the body? _________________________________________________________Did it cause bruising? ☐ Yes ☐ NoWas there a puncture wound? ☐ Yes ☐ NoWas there bleeding (torn skin)? ☐ Yes ☐ NoWere there multiple puncture wounds? ☐ Yes ☐ NoDid the dog bite, latch on and shake his head from side to side, not letting go? ☐ Yes ☐ NoHow did the incident end (for example, pulled dogs apart, one dog walked away, person ran away)?______________________________________________________________________________________________________________________________________________________________________________________What happened right after the incident (for example, put dog in yard, hit dog, dog lay down, dog looked “guilty”)?___________________________________________________________________________________________If there was a bite, was medical help sought?If there was a bite, was it reported?If there was a bite, was legal action taken?☐Yes ☐ No☐ Yes ☐ No☐ Yes ☐ No