TPC Behavioral Questionnaire

The Pet Connection charges a small fee ($25) for online behavioral consultation services. Please click on the buy now button below to pay for the consultation. Then, complete the below questionnaire and click submit.

Name (First & Last): *
Organization:
Address: *
City: *
State: *
Zip Code: *
Work Phone:
Home Phone: *
Fax:
E-mail Address: *
Pets Name: *
Pets Age: *
Pets Weight: *	Tiny (Under 10 lbs) Small (10 - 25 lbs) Medium (25 - 50 lbs) Large (50 - 90 lbs) Extra Large (Over 90 lbs)
Pets Gender: *	Female Male
Is Pet Spayed or Neutered? *	Yes No Unknown
Pet Species and Breed:
Pets Coloring:
Age of Pet when obtained?
Where was Pet obtained? *
What is the primary problem? *
Severity of problem: *	Mild Moderate Severe
Have you considered Euthanasia? *	Yes No
Comments:
Have you considered Rehoming? *	Yes No
Comments:
When did the problem begin?
Age of Pet when problem started?
What do you think caused the problem?
Please describe the most recent incident with as little emotion as possible but be descriptive. Such as Ears back, hiding beneath chair, growling, etc.
Please describe previous incidents:
Please describe first incident:
How often does the problem occur?
Has there been a change in frequency or severity? *	Yes No
Please describe any changes in the home or Pets health when the problem first started:
What has been done so far to correct the problem?
What was the Pets response?
Describe any techniques which have been successful:
Describe any techniques which have make the problem worse:


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After reading your answers, the consultant will send you other questions pertaining to your situation. Depending on your skill level and your problem, additional training or face-to-face training may be recommended. Please understand that this approach has limitations and we will try to work with you regarding these limitations. It will take 3-5 days for each response from our consultant. Please be patient with us.