Canine Behaviour Questionnaire

Obtaining this information prior to meeting allows best use to be made of the consultation time. Please be as accurate as possible

General Information



Is your dog neutered?:

Do you consider your dog to be, tick all those that apply:

Clients details


Early History 


Present Household 

Please include, breed, name, age, neutered and relationship with dog (avoids, plays, fights)
Please include name, age and Involvement (walks, feeds, grooms, play)
Please include name, involvement and frequency of attendance

Daily Routine








Behaviour Causing Concern 



Security Question:

Terms & Information

A behaviour diagnosis and treatment plan will be discussed during the consultation once information has been collected. A detailed report will then be emailed or posted in 1-2 weeks and a copy of the report will be sent to the referring veterinarian and attached to your clinical record. Support will be further provided by email or telephone, or external referral should it be deemed advisory.  

Pet behaviour therapy may produce results quickly, but it is often the case that time, commitment and consistency are required. The amount of progress made over time can vary according to the individual pet and owner compliance. Implementing the treatment plan always remains the caregiver’s responsibility, alongside responsibility for the pet’s welfare and behaviour.

The consultation fee includes, a report detailing the treatment plan, time spent on behalf of the behaviour clinician obtaining history, liasing with a veterinarian over diagnosis and processing the treatment plan and if required referral to external behaviourists. If follow up consultations should be required, an additional charge will be applied. This is because it is otherwise difficult for the clinician to assess the pet’s behaviour in full and because the behaviour diagnosis may have changed in the intervening period or other behaviours may develop in the diagnosis process. The consultation fee is payable at the time of the consultation.

Privacy Notice

IVC Rhyd Broughton Vets collects and processes personal information about you and your pet when you contact us for a behavioural service. This is essential for us to carry out the service effectively and fulfil our regulatory obligations. We use personal information collected for internal record keeping, and for passing onto a chosen external referral centre for corrective behaviour therapy. The choice of how much information you provide is always in your control, however, certain information may be required in order for us to provide a service. We will not distribute your personal information to third parties other than referring veterinarians unless we have your permission to do so or are required to by law or regulation.

Contact us and we will take the necessary steps subject to legal regulation - within 28 days of receipt.

Practice information

Wrexham Surgery

  • Mon
    8:30am - 7:00pm*
  • Tue
    8:30am - 7:00pm*
  • Wed
    8:30am - 7:00pm*
  • Thu
    8:30am - 7:00pm*
  • Fri
    8:30am - 7:00pm*
  • Sat
    8:30am - 12:30pm*
  • Sun
    9:00am - 11:00am*

Find us here:

Gatewen Road Wrexham LL11 6YA
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