DOG…………………………………
DATE IN ……………………
SURRENDER /POUND? ………………………………
ASSESSOR/CARER……………………………………
WEIGHT…………………………

BEHAVIOURS Y/N COMMENT WITH DETAILS  
Approachable by known person      
Approachable by unknown person      
Reacts at night time to person entering premises      
       
Sit      
Down      
Stay      
Other? Paw, roll, beg, play dead      
Signs of food aggression      
Any type of recall skills      
Walks on lead easily /Style of collar      
Shows interest in other dogs on other side of fence      
Does dog jump at fences/escape      
Play fetch/return      
Pulls at other dogs/people walking past      
Does dog travel well in car?      
       
Does dog have signs of anxiety      
Does dog destroy yard when left alone      
Any signs of dog aggression/ reactivity      
Any signs of previous abuse      
       
ENVIRONMENT      
Has dog met children      
Has dog met dogs      
Has dog met chickens      
Has dog met cats      
Toilet trained?      
Inside/outside dog      
Is dog crate trained      
Will this be a only dog      
CARE      
Flea Meds      
All Wormer      
Heartworm      
Special diet      
Any skin allergies      
       
OVERALL PERSONA