Separation Anxiety Questionnaire

If you believe your dog is suffering from separation related behaviors, please complete the following questionnaire. Once completed, we will email you a link to schedule the free 30-minute informational call. If you need help with other training issues, please see our referral page.

Separation Anxiety Questionnaire

Your Name *

Email Address *

Phone number

Can we text this number?

Yes

Location (City/State/Country)

Dog Name

Age and Gender of Dog

Breed or Mix Type (if known)

Where dog was acquired? (Shelter/Breeder/Other)

How long has dog been in your household?

How long is your dog currently being left alone? (Minutes/Hours)

What symptoms of separation anxiety does your dog exhibit? Please check all that apply:

Destruction, especially at exit points such as window and doors, sometimes to the point of self-injury

Excessive vocalization: whining, barking, howling when left alone

Elimination (accidents in the house), drooling, vomiting, diarrhea

Anxiety when you’re getting ready to leave

Pacing, trembling, or panting when left alone

Other

If you chose other, please describe the separation anxiety behavior your dog is experiencing:

Can you adjust your schedule (or make arrangements with daycare/pet sitter/friend) so that during training your dog will not have to be left alone?

Have you done any previous training to address your dog's separation anxiety? If yes, please explain.

Have you discussed your dog's separation anxiety with your veterinarian? If yes, please explain.

How long would you like to be able to leave your dog alone in the future (specify a range such as 2-4 hours)

Please let us know how you heard of us.

Captcha

After you click Submit, look for the green confirmation text box beneath the hand/paw heart photo for a link to schedule..

If you are human, leave this field blank.

We look forward to speaking with you!

Bob was an amazing partner helping with Bobby’s separation anxiety.

I learned so much about my dog which has enriched both of our lives.
I can leave him up to four hours now and he’s totally fine. So grateful to Bob!

– Heather McDonough, New York, NY