Online Behavior Help Application

Do you have a behavior issue with your pet? If so, our experts can help!
Just fill out and submit the form below and we will reply to you with helpful tips and suggestions.
We will try our best to attend to your issue as soon as possible,
but please allow up to a week for our response.

Please look over the materials in the Resource Library prior to submitting your question.
The answer to your question may already be there!

Note: If your question is regarding inappropriate elimination or housetraining, please strongly consider
consulting your veterinarian before contacting us.
These issues sometimes have an underlying medical problem, and it is best to rule that possibility out
before assuming the issue is behavioral.
In order to help us best address your pet’s behavior issue, please make your responses as detailed
and specific as possible.

Be ready to finish the questionnaire in one sitting, and don't navigate away from
this page until you are done. You can go back and edit your responses as much as you
like before you submit your final version.
click here to print the page for reference or to save a hard copy

yellow = this information is required for your application to be accepted

First Name
Last Name
Address1
Address2
City  State  Zip  
Main Phone          Alternate Phone  
Email Confirm Email
How did you hear about this service? (100)

Type of Animal dog cat rabbit rodent other    Breed
Other Type
Animal Name
Animal Gender Male Female Not Sure
Spayed or Neutered? Yes No Not Sure
Animal Age Years  0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25  Months  0 1 2 3 4 5 6 7 8 9 10 11 12    (if you don't know age leave the default of zero)
Last Vet Visit Month ??? Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec  Year  2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984    (if date is not known, leave ??? for the month)
What was the reason for last vet visit? (100)

Please list any medications your animal is currently taking (100)

How long have you had the animal?     Years  0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25  Months  0 1 2 3 4 5 6 7 8 9 10 11 12

Where did you obtain the animal? (75)

Please list any recent changes in your home or routines (100)

Who is the animal's primary caregiver? (100)

List any training this animal has received, classes, at home, etc? (100)

What type of exercise does your animal usually get and how often? (100)

Where does your animal spend the majority of the day? Inside, outside, crate, etc? (100)

Please estimate how many hours your animal is alone on a typical day?
 
Please list below all the other pets in your household, if more than 4, describe in 'Anything Else' at bottom
Name Type Breed AgeYY AgeMM Gender Spay/Neutered
         0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20     0 1 2 3 4 5 6 7 8 9 10 11 12     Male Female Not Sure   Yes No Not Sure
         0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20     0 1 2 3 4 5 6 7 8 9 10 11 12     Male Female Not Sure   Yes No Not Sure
         0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20     0 1 2 3 4 5 6 7 8 9 10 11 12     Male Female Not Sure   Yes No Not Sure
         0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20     0 1 2 3 4 5 6 7 8 9 10 11 12     Male Female Not Sure   Yes No Not Sure
Please describe the problem (be as detailed as possible) (2000)

How long has there been the problem?     Years  0 1 2 3 4 5  Months  0 1 2 3 4 5 6 7 8 9 10 11 12

What have you tried to do to correct the problem? (1000)

What has your animal’s response been to these measures? (1000)

Is there anything else we should know about? (1000)