Y=yes; U=unknown; N=no

The first set of these questions deals with an "actual absence" - e.g., the client actually leaves the house and the dog is either alone or totally without the client. The second set deals with "virtual absence" - e.g., the client is home, but not accessible because the door is closed or the dog is barricaded in another room. The questions are the same for each but please answer both.

Behaviors during an actual absence:

1.  Destructive behavior when separated from client:  Y U N

If yes,

•  100% of time (always)

•  <100% of time but >60% (more often than not)

•  40-60% of time (about equally)

•  >0% of time but < 40% (less often than not)

2.  Urination when separated from owner:  Y U N

If yes,

•  100% of time (always)

•  <100% of time but >60% (more often than not)

• 40-60% of time (about equally)

• >0% of time but < 40% (less often than not)

3.  Defecation when separated from owner:  Y U N

If yes,

• 100% of time (always)

• <100% of time but >60% (more often than not)

• 40-60% of time (about equally)

• >0% of time but < 40% (less often than not)

4.  Vocalization when separated from owner:  Y U N

If yes,

• 100% of time (always)

• <100% of time but >60% (more often than not)

• 40-60% of time (about equally)

• >0% of time but < 40% (less often than not)

5.  Salivation when separated from owner:  Y U N

If yes,  

• 100% of time (always)

• <100% of time but >60% (more often than not)

• 40-60% of time (about equally)

• >0% of time but < 40% (less often than not)

Behaviors during a virtual absence:

6.  Destructive behavior when separated from client:  Y U N

If yes,

• 100% of time (always)

• <100% of time but >60% (more often than not)

• 40-60% of time (about equally)

• >0% of time but < 40% (less often than not)

7.  Urination when separated from owner:  Y U N

If yes,

• 100% of time (always)

• <100% of time but >60% (more often than not)

• 40-60% of time (about equally)

• >0% of time but < 40% (less often than not)

8.  Defecation when separated from owner:  Y U N

If yes,

• 100% of time (always)

• <100% of time but >60% (more often than not)

• 40-60% of time (about equally)

• >0% of time but < 40% (less often than not)

9.  Vocalization when separated from owner:  Y U N

If yes,

• 100% of time (always)

• <100% of time but >60% (more often than not)

• 40-60% of time (about equally)

• >0% of time but < 40% (less often than not)

10.  Salivation when separated from owner:  Y U N

If yes,  

• 100% of time (always)

• <100% of time but >60% (more often than not)

• 40-60% of time (about equally)

• >0% of time but < 40% (less often than not)

11.  Reaction during thunderstorms:  Y U N

If yes,  

• 100% of time (always)

• <100% of time but >60% (more often than not)

• 40-60% of time (about equally)

• >0% of time but < 40% (less often than not)

Type of response - please tick all that apply:

• salivate

• defecate

• urinate

• destroy

• escape

• hide

• tremble

• vocalize

• pace

12.  Reaction to fireworks:  Y U N

If yes,  

• 100% of time (always)

• <100% of time but >60% (more often than not)

• 40-60% of time (about equally)

• >0% of time but < 40% (less often than not)

Type of response - please tick all that apply:

• salivate

• defecate

• urinate

• destroy

• escape

• hide

• tremble

• vocalize

• pace

13. Reaction to other noises:  Y U N

Type of Noise:___________________

If yes,

• 100% of time (always)

• <100% of time but >60% (more often than not)

• 40-60% of time (about equally)

• >0% of time but < 40% (less often than not)

Type of response - please tick all that apply:

• salivate

• defecate

• urinate

• destroy

• escape

• hide

• tremble

• vocalize

• pace