Barking Questionnaire

Barking is a very common problem. This questionnaire was to designed to help determine the cause of the barking problem.

Please complete this questionnaire to help us best understand your pet's health needs.

Client Details

Client first name

Client last name

Phone number

Email address

Address

Pet Details

Animal name

Animal species (e.g. dog, cat)

Animal breed

Animal sex (e.g. male, female)

Animal age/DoB

Animal microchip

BARKING HISTORY

Has a formal complaint been made with regard to your dog barking?
Yes
No

Other:

How would you describe the bark?
   Territorial
   Alarm
   Attention-seeking
   Greeting
   Compulsive and repetitive
   Socially to respond to another dog in the distance
   Frustrated because they cannot access what they want
   Other

Other:

How would you describe the bark behavior?
   Short-lived and stops when the stimulus is removed
   Stops when the owner is present or when the pet receives attention
   Rises to a peak, decreases and starts all over
   Consistent, monotone and persistent
   None of the above

OVERALL HEALTH

Apart from the barking, please describe any other health concerns.

By submitting this form, I acknowledge that I am the owner or agent representing the pet named above and that the information here is true and correct.

Date today