Match-Up II Shelter Dog Rehoming Program / Behavior Evaluation Worksheet

Transcription

1 Dog Name: Date: ID # : Match-Up II Shelter Dog Rehoming rogram / Behavior valuation Worksheet ersonality Scoring Instructions: Behaviors are grouped into personality traits. Certain behaviors within these traits are assigned a score, from 0 to, based on how strongly they reflect a trait. Review the behavior evaluation and, for each sub-test, enter the highest score for each trait. Do not add scores, use only the behavior which received the highest score. For example, if a dog both licked and sniffed the person in Sub-est, you would enter a score of for iendliness for Sub-est as lick receives a higher score than sniff. =iendly, =arful. =xcitability, =ggressiveness, =layfulness, =rainability Handler : lease use this worksheet to record the behaviors observed for all sub-tests. o mark a behavior, place a check mark in the box next to the beahvior. You will also need to refer to the personlaity scoring box next to the behavior that is chcked off. Recorder : Overall ersonality Scores o calculate total ersonality Scores, add together all the ersonality Scores from all sub-tests and enter them here. iendliness out of 4 max xcitablity out of max layfulness out of max arfulness out of 6 max ggressiveness out of 6 max rainability out of 5 max te: Behaviors in bold italics receive points on the Behavioral riage form (see form for more information). Short descriptions of each sub-test are provided below as a reminder or how to conduct the sub-test but please refer to the manual for the complete description. SUB-S BHVIORS. Leash Manners Handler walks dog outside. Observe leash behavior and report to Recorder. Doesn t ull ulls Lightly ulls Medium ulls Hard Grabs Leash with Mouth *May select this box along with behavior. Room Behavior art : xplore mins Handler drops leash when entering room and sits in chair in middle of room. Watch but do not talk to or interact with dog during the min. Lick erson Nudge Hand on erson Stay Near erson 5+ Sec Sniff erson Run way from erson Back way from erson Mount erson aw erson pproach erson erson Body ail Mouth Vocalizations remble laybow Wag ail uck ail ars Back ars x + Hard Mouth erson Soft Mouth erson Show eeth for Sub-test. iendliness arfulness xcitablity ggressiveness layfulness (ick behavior with the highest Match-Up II Behavior valuation of 8

2 Dog Name: Date: ID # : Handler : Recorder :. Room Behavior art : Call Over Handler calls dog over, Come, [name], come, no hands or other sounds first time. If dog doesn t come, repeat. If dog still doesn t come, try a third time, clapping hands on lap, making kissing sounds. et dog with long strokes if comes over. Lick erson Nudge Hand on erson Stay Near erson 5+ Sec Sniff erson Run way from erson Back way from erson Mount erson aw erson pproach erson erson Body ail Mouth Vocalizations remble laybow Wag ail uck ail ars Back ars x + Hard Mouth erson Soft Mouth erson Show eeth for Sub-test. iendliness arfulness xcitablity ggressiveness HIghest layfulness (ick behavior with the highest *Did the dog come when called? *Number of times asked? Instructions for this task can be found in the Match- Up II training manual.. Commands Sit Down Sit / Stay Come Shake Did t Respond Completed fter One Request Completed fter wo Requests Completed fter hree Requests Did t Respond Completed fter One Request Completed fter wo Requests Completed fter hree Requests Did t Respond Completed fter One Request Completed fter wo Requests Completed fter hree Requests Did t Respond Completed fter One Request Completed fter wo Requests Completed fter hree Requests Did t Respond Completed fter One Request Completed fter wo Requests Completed fter hree Requests for Sub-test rainability Max 5 *dd scores up for each command and enter in box, rather than selecting the highest as you do in all other sub-tests. Match-Up II Behavior valuation of 8

3 Dog Name: Date: ID # : 4. Handling et Have dog stand (sitting is okay if dog won t stand). Discontinue sub-test if dog won t stand or sit. Handler stands on dog s right side, holding collar with right hand. Using the left hand, pick up the rear inside foot, then front inside foot, then rear outside foot, then front outside foot. Make sure to hold the foot, not the ankle. Hold each foot for two seconds. Stay aware of dog s head for safety. Lick erson Nudge Hand on erson Sniff erson Back way from erson Mount erson pproach erson erson Body ail Mouth Vocalizations remble Lie Down/Lie on Side Roll on Back Head Whip Wag ail uck ail ars Back ars x + Hard Mouth erson Soft Mouth erson Show eeth Handler : Yelp Dog Sat for Sub-est Dog would not Sit or Stand, Sub-est Discontinued Recorder : for Sub-test 4 iendliness arfulness xcitablity HIghest ggressiveness (ick behavior with the highest 5. oys art : Ball Handler drops leash and holds ball so that dog sees it. hrow ball, wait to see if dog returns to handler. If doesn t, call dog. Walk to dog if doesn t return. Wait to see if dog drops toy. If not, ask to drop, then give, then out. If doesn t, trade for treat. Runaway from oy (without oy) Back way from oy (without toy) Bring oy Back ick Up oy in Mouth pproach oy When hrown Does t pproach oy When hrown Move way with oy Drop oy Command Drop oy on Command raded oy Reluctant to rade oy erson ail Mouth Vocalizations On erson pproach erson remble laybow Body Wag ail uck ail ars Back ars x + Hard Mouth erson Soft Mouth erson Show eeth lay for Sub-test 5. iendliness arfulness xcitablity ggressiveness layfulness Higjest (ick behavior with the highest Match-Up II Behavior valuation of 8

4 Dog Name: Date: ID # : 5. oys art : lush Squeaky oy Handler squeaks toy then throws it. Wait to see if dog returns to handler. If doesn t, call dog. Walk to dog if doesn t return. Wait to see if dog drops toy. If not, ask to drop, then give, then out. If doesn t, trade for treat. Runaway from oy (without oy) Back way from oy (without toy) Bring oy Back ick Up oy in Mouth pproach oy When hrown Does t pproach oy When hrown Move way with oy Drop oy Command Drop oy on Command raded oy Reluctant to rade oy erson ail Mouth Vocalizations On erson pproach erson remble laybow Was there any destruction of the squeaky toy (ripping, tearing, shredding)? Body Wag ail uck ail ars Back ars x + Hard Mouth erson Soft Mouth erson Show eeth Handler : lay Recorder : for Sub-test 5. iendliness arfulness xcitablity ggressiveness layfulness (ick behavior with the highest 5. oys art : ug oy Handler wiggles the tug toy on the ground in front of the dog to engage. ncourage the dog to tug by saying tug. ry three times for 5 seconds each time. If dog will tug, play tug for 0 seconds. Repeat drop exercise as for ball. Runaway from oy (without oy) Back way from oy (without toy) lay ug ake oy in Mouth (but does not play tug) Drop oy Command Drop oy on Command raded oy Reluctant to rade Would you call dog s play style with the tug intense? oy erson ail Mouth Vocalizations On erson pproach erson remble laybow Body Wag ail uck ail ars Back ars x + Hard Mouth erson Soft Mouth erson Show eeth lay for Sub-test 5. iendliness arfulness xcitablity ggressiveness layfulness (ick behavior with the highest Match-Up II Behavior valuation 4 of 8

5 Dog Name: Date: ID # : 6. Run & eeze With dog dragging leash, Handler gently taps dog on back and then runs across room (0-40 feet), giggling and waving arms. Suddenly stop and fold arms, ignoring dog. Repeat from that point (call or lead dog over if not nearby). If dog hard mouths, mounts, growls at or bites the Handler, SO! Lick erson Nudge Hand on erson Stay Near erson 5+ Sec Sniff erson Run way from erson Back way from erson Mount erson aw erson pproach erson erson Body ail Mouth Vocalizations remble laybow Wag ail uck ail ars Back ars x + Hard Mouth erson Soft Mouth erson Show eeth Handler : Recorder : for Sub-test 6 iendliness arfulness xcitablity ggressiveness layfulness (ick behavior with the highest 7. Rubber Hand Introduce Rubber Hand Recorder holds the dog on leash. Handler hides stick underneath clothing or lays flat against arm with the rubber hand in view and approaches the dog. With the hand close to the dog s head, allow the dog to investigate (sniff, lick, chew, bite). te in comments section if dog seems playful, fearful, or aggressive. Lick Hand Sniff Hand Back way from Hand pproach Hand Hand Body ail Mouth Vocalizations remble Wag ail uck ail ars Back ars x + Hard Mouth Hand Soft Mouth Hand Show eeth layful with Hand (as if toy) Mouthing Match-Up II Behavior valuation 5 of 8

6 Dog Name: Date: ID # : 8. ossessiveness art : Wet Food ether dog. Handler places bowl on floor & pushes forward with rubber hand so no tension on leash. llow dog to begin eating. Walk past dog with rubber hand hanging down. et dog s head and body with hand. Move hand around outside of bowl, edge, inside, right next to dog s mouth. Hand should be next to but not touching or pushing dog s head. ull bowl away with hand, push back, pull away, then remove bowl. at Food Stop ating Before Hand Stop ating But Doesn t Back way fter Hand Introduced Stop ating and Back way fter Hand Introduced at Food Faster fter Hand Introduced Food Body ail Mouth Vocalizations remble Wag ail uck ail ars Back ars x + Show eeth ethered Held Reactive to tethering Dog did not eat, Sub-est discontinued If dog shows teeth, growls, snaps, or bites on any part of the sub-test, indicate which part: Walk by et Dog Hand next to, on, or in bowl ull bowl away (either time) Handler : Recorder : for Sub-test 8. iendliness arfulness xcitablity ggressiveness (ick behavior with the highest 8. ossessiveness art : ig s ar Must use pig s ear & mat/ rug. ether dog. Handler places/tosses ear on mat so no tension on leash. llow dog to chew for approx. 0 sec before using hand. et dog s head, body, then place hand near ear. Move hand closer and touch ear. See if dog will trade for treat. Chew ar Stop Chewing Before Hand Move way with ar Before Hand Stop Chewing fter Hand Introduced Move way with ar fter Hand Introduced Drop ar fter Hand Introduced raded ar ig s ar Body ail Mouth Vocalizations remble Wag ail uck ail ars Back ars x + Show eeth ethered Held Reactive to tethering for Sub-test 8. iendliness arfulness xcitablity ggressiveness (ick behavior with the highest Reluctant to rade Dog did not eat, Sub-est discontinued If dog shows teeth, growls, snaps, or bites on any part of the sub-test, indicate which part: et dog Hand near ear Hand on ear Match-Up II Behavior valuation 6 of 8

7 Dog Name: Date: ID # : Handler : Recorder : 9. oddler Doll Handler holds leash while Recorder carries toddler doll into the room like a child, stopping approximately 8 feet away. lace doll on ground in a standing position and walk doll forward. t about feet away, stop and extend doll s arm. llow dog to approach if desired. If the dog is fearful of doll, wait 0 seconds to see if the dog recovers from fear. Do not reassure the dog at this time. Doll Body ail Mouth Vocalizations Stay Near Doll Wag ail 5+ Sec Lick Doll remble uck ail Hard Mouth erson / Doll on Doll Nudge Doll x Soft Mouth erson ars + / Doll Sniff Doll ars Back Run way from layful with Doll Doll (as if toy) Back way from laybow Does not recover from Doll fear within 0 sec Mount Doll Show eeth aw Doll pproach Doll for Sub-test 9 iendliness arfulness xcitablity ggressiveness layfulness (ick behavior with the highest 0. Strange-Looking Woman Handler holds leash. Recorder enters dressed in a trench coat, hat, sunglasses and cane. Stop at any sign of aggression. Recorder says Hi, doggie, can I pet you? If no aggression occurs, approach, saying Hi, doggie, are you a nice doggie? When feet away, the Recorder reaches out with a closed hand to allow the dog to sniff if desired. llow dog to approach if desired. If the dog is fearful of the woman, maintain position without moving (can drop hand) and wait an additional 0 seconds to see if the dog recovers. Do not reassure the dog at this time. Lick erson Nudge erson on erson Stay Near erson 5+ Sec Sniff erson Run way from erson Back way from erson Mount erson aw erson pproach erson erson Body ail Mouth Vocalizations remble laybow Wag ail uck ail ars Back ars x + Hard Mouth erson Soft Mouth erson Show eeth arful of Cane layful with Cane Does not recover from fear within 0 sec for Sub-test 0 iendliness arfulness xcitablity ggressiveness layfulness (ick behavior with the highest Match-Up II Behavior valuation 7 of 8

8 Dog Name: Date: ID # :. Dog-to-Dog Interaction art : Dog If possible, use a dogfriendly dog approximately the same size as the dog being evaluated. Walk dogs past each other about three feet away. Stop if any aggression or concern. If none, allow to greet. te any other playful behaviors in the comments section. Lick Dog on Dog Sniff Dog Run way from Dog Back way from Dog aw Dog pproach Dog Dog Body ail Mouth Vocalizations remble (not on person/dog) iloterect laybow Head Whip Wag ail uck ail ars Back ars x + to Dog to Dog Show eeth Mouthing Handler : lay Does not recover from fear within 0 sec Recorder : for Sub-test. iendliness Max arfulness Max xcitablity Max ggressiveness Max layfulness Max Calculate trait scores for only one dog sub-test. Roll on Back Lie Down/Lie on Side Dog s Name: M N F S (circle). Dog-to-Dog Interaction OIOL art : Dog If possible, use a dogfriendly dog approximately the same size as the dog being evaluated. Walk dogs past each other about three feet away. Stop if any aggression or concern. If none, allow to greet. te any other playful behaviors in the comments section. Lick Dog on Dog Sniff Dog Run way from Dog Back way from Dog aw Dog pproach Dog Dog Body ail Mouth Vocalizations remble (not on person/dog) iloterect laybow Head Whip Roll on Back Lie Down/Lie on Side Dog s Name: M N F S (circle) Wag ail uck ail ars Back ars x + to Dog to Dog Show eeth Mouthing lay Does not recover from fear within 0 sec for Sub-test. iendliness Max arfulness Max xcitablity Max ggressiveness Max layfulness Max Calculate trait scores for only one dog sub-test. w add up all scores for each personality trait for all sub-tests, and place the sum in the overall personality scores chart on page of the Behavior valuation worksheet Match-Up II Behavior valuation 8 of 8

9 Behavioral riage Dog s Name: ID# M N F S Breed: ge: OL RIG OINS: SCION : BHVIORL HISORY refer to Intake History. NO INK HISORY VILBL (Check box) Check box on the right, if no intake history and skip to Section. dd pts to Section Behavioral History otal. + B. GGRSSION (Check box). ttack or uninhibited bite resulting in severe injury to a person (such as a bite that requires stitches or multiple bites even if no medical care is required) +50. o dults Check all that apply, then circle and add only the highest points to Section Behavioral History otal. (Check box). Show teeth, growl dults Men Women B. dults Men Women C. Bite dults Men Women te: If aggression in a-c occurs while breaking up a dog fight or if the dog was in severe pain subtract 5 points. SUBRC a maximum of 5 points in this section. If any aggression to adults in Sub-Section, answer the following questions but don't add any points (target is always an adult): Was it over food?.. Was it over bones, rawhides, or chews?.. Was it over toys?.4. Was it over stolen objects?.5. Was it when the dog was disturbed while sleeping or resting?.6. Was it when a person handled the dog (brushing, handling feet, bathing, teeth brushing, ear cleaning, etc. but do NO include reaction to vet or groomer)?.7. Was it when a person entered the house or yard?.8. Was it when a person approached or reached toward the dog?. o Children Check all that apply but add only the highest points to Section Behavioral History otal.. Show teeth, growl Children B. Children C. Bite Children te: If aggression in a-c occurs while breaking up a dog fight or if the dog was in severe pain subtract 5 points. SUBRC a maximum of 5 points in this section. (Check box) Dog s Name: ID# Date Behavioral riage oints Form of 9

10 If any aggression to children in Sub-Section, answer the following questions but don't add any points (target is always an child):.. Was it over food?.. Was it over bones, rawhides, or chews?.. Was it over toys?.4. Was it over stolen objects?.5. Was it when the dog was disturbed while sleeping or resting?.6. Was it when a child handled the dog (brushing, handling feet, bathing, teeth brushing, ear cleaning, etc but do NO include reaction to vet or groomer)?.7. Was it when a child entered the house or yard?.8. Was it when a child approached or reached toward the dog? 4. o Vet/Groomer Check all that apply but add only the highest points to Section Behavioral History otal. (enter points only if no points received for aggression to adults). Show teeth, growl Vet or groomer ONLY B. Vet or groomer ONLY C. Bite Vet or groomer ONLY 5. o Dogs Check all that apply but add only the highest points to Section Behavioral History otal.. Show teeth, growl Dogs B. Dogs C. Bite Dogs D. ttack resulting in severe injury or death to a dog 6. o nother Domesticated nimal Species (cat, livestock, not small pets like hamsters, guinea pigs, etc.) Check all that apply but add only the highest points to Section Behavioral History otal.. Show teeth, growl nother domesticated animal species B. nother domesticated animal species C. Bite nother domesticated animal species D. ttack resulting in severe injury or death to a dog to another domesticated animal species C. OHR BHVIORL ROBLMS Check all that apply and DD LL points to Section Behavioral History otal.. ing, destructive behavior, OR house soiling only when left alone (separation anxiety, not puppy behavior). Dog returned or more times due to behavioral reasons. scaping times or more in last 6 months 4. Chasing cars, motorcycles, joggers, cyclists, skateboarders, or rollerbladers 5. Uncontrollable chasing of cats, squirrels or other small animals SCION : BHVIORL HISORY OL: Dog s Name: ID# Date Behavioral riage oints Form of 9

11 SCION : BHVIORL VLUION refer to Behavior valuation Scoring Sheet (lease note: the behaviors noted below are the bolded behaviors on the evaluation worksheet.) SUB-S ROOM BHVIOR (art or ) Check all that apply FROM NY R OF H SUB-S, and add to Section : Behavior valuation otal. But if multiple behaviors within one behavior category (eg. excitability, aggression), add only the highest points from that category to the total arfulness:, run away, tremble, hide xcitability: Soft mouth, jump up on person/doll/dog xcitability: Hard mouth, grab clothing/body, mount ggressiveness: Show teeth, growl ggressiveness: ggressiveness: Bite SUB-S 4 HNDLING: F Check all that apply FROM NY R OF H SUB-S, and add to Section : Behavior valuation otal. But if multiple behaviors within one behavior category (eg. arousal, aggression), add only the highest points from that category to the total arfulness:, tremble xcitability: Soft mouth, jump up on person/doll/dog xcitability: Hard mouth, grab clothing/body, mount ggressiveness: Show teeth, head whip, growl ggressiveness: ggressiveness: Bite SUB-SS 5: RS,, or OYS Check all that apply FROM NY R OF H SUB-S, and add to Section : Behavior valuation otal. But if multiple behaviors within one behavior category (eg. arousal, aggression), add only the highest points from that category to the total arfulness:, run away, tremble, hide xcitability: Soft mouth, jump up on person/doll/dog xcitability: Hard mouth, grab clothing/body, mount ggressiveness: Show teeth, growl (not a play growl) ggressiveness: ggressiveness: Bite Dog s Name: ID# Date Behavioral riage oints Form of 9

12 SUB-S 6 RUN ND FRZ Check all that apply FROM NY R OF H SUB-S, and add to Section : Behavior valuation otal. But if multiple behaviors within one behavior category (e.g. excitement, aggression), add only the highest points from that category to the total. arfulness:, run away, tremble, hide xcitability: Soft mouth, jump up on person/doll/dog xcitability: Hard mouth, grab clothing/body, mount ggressiveness: Show teeth, growl ggressiveness: ggressiveness: Bite SUB-S 8: art OSSSSIVNSS: FOOD Check all that apply but only add the highest points to Section : Behavior valuation otal. ggressiveness: Show teeth, growl ggressiveness:, inhibited bite to rubber hand ggressiveness: Uninhibited bite to rubber hand + SUB-S 8: art OSSSSIVNSS: IG S R Check all that apply but only add the highest points to Section : Behavior valuation otal. ggressiveness: Show teeth, growl ggressiveness:, inhibited bite to rubber hand ggressiveness: Uninhibited bite to rubber hand + SUB-S 9 ODDLR DOLL Check all that apply FROM NY R OF H SUB-S, and add to Section : Behavior valuation otal. But if multiple behaviors within one behavior category (e.g. excitability, aggression), add only the highest points from that category to the total. arfulness (doesn t recover within 0 sec):, run away, tremble, hide xcitability: Soft mouth, jump up on person/doll/dog xcitability: Hard mouth, grab clothing/body, mount ggressiveness: Show teeth, growl ggressiveness: ggressiveness: Bite Dog s Name: ID# Date Behavioral riage oints Form 4 of 9

13 SUB-S 0 SRNG-LOOKING WOMN Check all that apply FROM NY R OF H SUB-S, and add to Section : Behavior valuation otal. But if multiple behaviors within one behavior category (eg. excitability, aggressiveness), add only the highest points from that category to the total. arfulness (doesn t recover within 0 sec):, run away, tremble, hide xcitability: Soft mouth, jump up on person/doll/dog xcitability: Hard mouth, grab clothing/body, mount ggressiveness: Show teeth, growl ggressiveness: ggressiveness: Bite SUB-S (art or ) DOG-O-DOG INRCION Check all that apply FROM NY R OF H SUB-S, and add to Section : Behavior valuation otal. But if multiple behaviors within one behavior category (eg. arousal, aggression), add only the highest points from that category to the total. arfulness (doesn t recover within 0 sec):, run away, tremble, hide ggressiveness: Show teeth, growl (not a play growl) ggressiveness: ggressiveness: Bite SCION : BHVIOR VLUION OL: Dog s Name: ID# Date Behavioral riage oints Form 5 of 9

14 SCION : BHVIOR OBSRVD IN SHLR ny information about a dog's behavior in a shelter enviornment should be entered here, including info from a past stay at another shelter, past evaluation, etc.). GGRSSION. ttack or uninhibited bite resulting in severe injury to a person (such as a bite that requires stitches or multiple bites even if no medical care is required) +50. o dults Check all that apply but add only the highest points to Section Behavior Observed in Shelter.. Show teeth, growl dults Men Women B. dults Men Women C. Bite dults Men Women te: If aggression in a-c occurs only when the dog is in or being returned to cage subtract 4 points. If aggression occurs while breaking up a dog fight or if the dog was in severe pain subtract 5 points. Subtract a maximum of 5 points in this section. If any aggression to adults in Sub-Section, answer the following questions but don't add any points (target is always an adult): Was it over food?.. Was it over bones, rawhides, or chews?.. Was it over toys?.4. Was it over stolen objects?.5. Was it when a person handled the dog (brushing, handling feet, bathing, teeth brushing, ear cleaning, etc but do NO include reaction to vet or groomer)?.6. Was it when a person approached or reached toward the dog?. o Children Check all that apply but add only the highest points to Section Behavior Observed in Shelter.. Show teeth, growl Children B. Children C. Bite Children te: If aggression in a-c occurs only when the dog is in or being returned to cage subtract 4 points. If a bite or a snap occurs while breaking up a dog fight or if the dog was in severe pain subtract 7 points. Subtract a maximum of 7 points in this section. If any aggression to adults in Sub-Section, answer the following questions but don't add any points (target is always a child):.. Was it over food?.. Was it over bones, rawhides, or chews?.. Was it over toys?.4. Was it over stolen objects?.5. Was it when a child handled the dog (brushing, handling feet, bathing, teeth brushing, ear cleaning, etc but do NO include reaction to vet or groomer)?.6. Was it when a child approached or reached toward the dog? Dog s Name: ID# Date Behavioral riage oints Form 6 of 9

15 4. o Vet/Groomer Check all that apply but add only the highest points to Section Behavior Observed in Shelter. (Omit points here if dog already received points for aggression to adults in previous section). Show teeth, growl Vet or groomer ONLY B. Vet or groomer ONLY C. Bite Vet or groomer ONLY o Dogs Check all that apply but add only the highest points to Section Behavior Observed in Shelter.. Show teeth, growl Dogs B. Dogs C. Bite Dogs D. ttack resulting in severe injury or death to a dog o nother Domesticated nimal Species (cat, livestock, not small pets like hamsters, guinea pigs, etc.) Check all that apply but add only the highest points to Section Behavior Observed in Shelter.. Show teeth, growl nother domesticated animal species B. nother domesticated animal species C. Bite nother domesticated animal species D. ttack resulting in severe injury or death to another domesticated animal species B. FR (doesn t recover) Check all that apply and DD LL points to Section Behavior Observed in Shelter otal.. eople:, run away, tremble to most new people. nvironment:, run away, tremble city noises, thunder, etc C. XCIMN Check all that apply and DD LL points to Section Behavior Observed in Shelter otal.. Soft mouth, jump up but does not grab clothing/body. Hard mouth, jump up and grab clothing/body, mount + D. CHSING Check all that apply and DD LL points to Section Behavior Observed in Shelter otal.. Chasing cars, motorcycles, joggers, cyclists, skateboarders, or rollerbladers. Uncontrollable chasing of cats, squirrels or other small animals + + SCION : BHVIOR OBSRVD IN SHLR OL: Dog s Name: ID# Date Behavioral riage oints Form 7 of 9

16 SCION 4: DOG'S WIGH (lease note: weight point must only be added if the dog receives points for aggressiveness or excitability.) Under 5 lbs. 5-9 lbs. 0-9 lbs. 0-9 lbs lbs lbs. 60+ lbs SCION 4: DOG'S WIGH OL: SCION : BHVIORL HISORY: SCION : BHVIOR VLUION: SCION : BHVIOR OBSRVD IN SHLR: SCION 4: DOG'S WIGH OL: OL RIG OINS: Dog s Name: ID# Date Behavioral riage oints Form 8 of 9

17 riage oint Range Descriptions 0- oints he dog exhibited few or no problematic behaviors and is likely to be a good candidate for adoption with routine screening and counseling. 4-0 points he dog exhibited some problematic behaviors and is likely to be a candidate for adoption into a selected home. he dog may benefit from behavior modification training in the shelter and/or problem-based behavior counseling. + oints he dog exhibited numerous and/or severe problematic behaviors and should be evaluated carefully in terms of adoption prospects in the community. If it is decided to place dog the dog is likely to benefit from behavior modification training in the shelter and/or problem-based behavior counseling. riage Outcome Categories lease indicate your shelter's recommendation for the dog below: 0 oints, ggression ted: Suitable for adoption with routine screening and counseling 4+ lus oints or 0 - oints with ggression ted: Suitable for adoption with routine screening and counseling, may have some restrictions. Suitable for adoption with problem-based behavior counseling required. Suitable for adoption with both behavior modification training and problem-based behavior counseling required. Suitable for adoption with behavior modification training, problem-based behavior counseling, and post-adoption counseling required. Suitable for interim placement into a foster home or training facility for behavior modification, followed by re-evaluation. t suitable for adoption into a community (household) setting. Recommended Behavioral raining Based on the information entered about this dog from Behavioral History, Behavior valuation, and/or Behavior in the Shelter, this dog may be a candidate for the following training programs: (check off all that apply) Jumpy/Mouthy Food ggression ggression to eople ggression when Handled ggression to Dogs Jumpy/Mouthy ar of eople Separation nxiety Specific nvironmental ar : : Manager/Behavior Department Manager/Behavior Department approval: Date: Behavioral riage oints Form 9 of 9