CONNECTICUT HUMANE SOCIETY-DOG PET PERSONALITY PROFILE (PPP)
CHS EMPLOYEE CONDUCTING THE EVALUATION: ___________________
The following questionnaire is used to help us learn about your dog. We use this information to help find the best possible home and
prepare your pet’s new family with information about his/her history. Please complete this questionnaire as completely and accurately
as possible. Undesirable behaviors or medical issues do not necessarily prevent placement but failure to disclose them does.
BASIC INFORMATION:
Dog’s Name:
Sex:
 Male
 Female
 Altered
 Unsure
Age or DOB:
Breed & Color:
How long has this pet lived with you?
How many previous owner has he/she had?
 Other Rescue
 Giveaway
 Breeder
 Stray
Where did you get this pet?  CT Humane Society
 Offspring from pet
 Pet Store
 Relative
 Friend
 Abandoned
If you got this pet from a previous owner, why did they give this pet away?
CARE & HEALTH:
What Vet Hospital cares for this pet?
How does this dog react at the Vet?
Is this pet on any medication or special diet?  No  Yes
Does this pet have any current or past medical problems?  No  Yes
Has this pet displayed any changes in behavior, appetite or thirst lately?  No
If yes, please explain:
Phone or Town:
 Yes
 No  Yes
Details:
Has this pet: Been vaccinated regularly?

No

Yes
Details:
Had reactions to vaccines or medication?

No

Yes
Details:
Been bitten by another animal?
If this pet is spayed or neutered, how old was he/she when the surgery was done?
Yes  Number:
Is this pet microchipped? No 
 Dry  Canned
 Mix
Brand?
What type of food does this pet eat?
How often is he/she fed?  Morning Only  Evening Only  Morning and Evening
 Treats  A Raw Diet Other:
Does this pet get:  Table Scraps
Has this pet ever been boarded?
 No
 Yes
Scanned?
No 
Yes 
 Free fed
Details:
SOCIAL BEHAVIOR:
How would you describe this dog most of the time? (check all that apply):  Playful  Couch Potato  Vocal/Barker
 Friendly/loving
 Withdrawn/Shy  Shy w/ visitors
 Independent
 Fearless
 Outgoing/Affectionate  Solitary/Aloof
 Friendly w/ visitors  Quiet
 Fearful
 Adult Men  Adult Women  Seniors
 Children (ages:_________)
What ages/types of people lived with this
dog?
 Played together
If this dog lived with children, how did they interact?  Mutual adoration  Child could pet the dog
 Dog hid from the child  Dog avoided the child but did not hide  Ignored each other
 Dog growled at child
Other:
How does this dog react to visitors?
Does he/she jump on strangers?  No  Yes
 Very active
 Somewhat active
 Quiet & Serene
How active is your home?
What breeds, ages, genders, size other pets lived with this dog?
If this dog lived with cats, how did he/she behave?  Adored each other  Played together  Peacefully coexisted
 Ignored each other  Groomed each other
 Sniffed noses
 Fought w/out injury  Fought w/ injury
If this dog lived with dogs, how did he/she behave?  Adored each other  Played together  Peacefully coexisted
 Ignored each other  Groomed each other
 Sniffed noses
 Fought w/out injury  Fought w/ injury
If this pet never lived with other animals, has he/she ever interacted with:
Dogs:  Never been around dogs
 Ignore each other
 Friendly w/ some dogs
 Friendly w/ all dogs
 Gentle or Submissive
 Friendly/Playful
 Unfriendly w/ some dogs
 Unfriendly w/ all dogs
 Bossy or Dominant
 Rough houses
 Unfriendly w/ same sex dogs  Unfriendly on leash
 Frightened
Other:
Cats:  Never been around cats
 Ignore each other  Aggressive
 Has killed a cat
 Frightened
 Gentle or Submissive
 Friendly/Playful
 Chases for fun
 Chases to harm
 Respectful
 Bossy or Dominant
 Rough houses
Other:
1- Rev. August 2011
How does this dog like to play with people?  No interest in play
 Plays rough and won’t stop
 Likes to learn tricks for treats
 Plays rough but stops when told  Plays in and around water
 Enjoys Tug-O-War
 Likes hide & seek
Other:
 Plays gently
 Fetches
 Likes to herd or nip
 Respectfully
 Very mouthy
 Likes to chase
How does this pet behave/react when he/she sees wild animals?
How often is this dog home alone and where does it stay?
Where does this dog stay at night?
HABITS & BEHAVIOR:
 In & Outdoors Other:
Where does this pet live?  Indoor  Outdoor
If indoor/outdoor, when is he/she allowed out and for how long?
 Partially fenced yard  Tied Out
When outdoors, how is this pet contained?  Fully fenced
yard
 Leashed/Harnessed  Not Contained Other:
What equipment do you use to walk this dog?  Leash  Harness  Head Collar  Nothing
 No  Yes Details:
If this pet is allowed off leash, does he/she return when called?
Has this pet ever exhibited any aggression or bitten anyone?
 No
 Yes
Details:
 Inactive
How active is this pet?  Very active  Somewhat active
How does this dog spend the majority of its time?
Is this dog crate trained?  No  Yes Why?
 Run of the house
 Outside  Basement
When alone, where does this dog stay?
 Other Room What Room & Why?
 Somewhat Vocal
 Non-Vocal
How vocal is this dog?  Very Vocal
Does this dog bark, howl or whine when home alone?  No  Yes Describe:
 Visitors
What does this dog bark or howl at or about?  Strangers
 Other Dogs
 Cats
 Men
 Women
 Unknown reason
Describe:
 When Alone
 For Food
 To go outside  Other:
 No  Yes
Does this dog stop vocalizing if you redirect them?
When does this dog whine?
 Invisible Fence
 Garage
 To go outside
 Wildlife
 Children
 For Attention
 Crate
 For food
 When alone
 Delivery People
 When he/she seems scared
Describe:
Is this pet housebroken?  No  Yes How does he/she let you know he/she needs to go out?
How often is this dog walked to: Go to the bathroom?
Get exercise?
Describe your pet’s exercise routine:
 Outside
 Wee Wee Pad
Other:
Where does this dog go to the bathroom?
Describe your pet’s housebreaking / potty break routine:
 Yes, urinates
 Yes, defecates
 Yes, both
Does he/she ever have accidents inside?  No
 Daily
 Weekly
 Once in a while
If yes, how often? Urine:
Stool:
 Daily
 Weekly
 Once in a while
How does this dog react in the car?
Is this dog frightened of anything?
 No
 No  Yes Details
Does this dog have any behavior ‘quirks’?
 No  Yes
Does this dog have any bad habits a new adopter should know about?
Have you tried to correct this behavior?  No  Yes
Does this dog jump over fences?  No  Yes Describe:
 No  Yes Describe:
Has this dog ever escaped?
 No  Yes Describe:
Does this dog get into mischief like raiding the trash?
 No  Yes Describe:
Does this dog steal food off the table or counter?
Does this pet display destructive behaviors like chewing or digging?  No  Yes Describe:
What is this dog’s best quality?
2- Rev. August 2011
 Yes
Dogs Name:
Date of Intake:
O/G Surrender
Witness
No Admit/Request
Evaluator:
Category
Range
A
B
C
D
F
Range
Social Int.
Friendly
Aggressive
Body Lang.
Soft eyes/body
Lunging/Growling/Snapping
Stress Level Calm
Shedding/Displacing/Avoidance
Training
Motivated
Unable to Get Attention
Separation
Adjusted/Calm
Extreme Anxiety/Harm to Self
Food Bowl
Leaves Food to Greet
Leaves Bowl to Bite
Resources
No Interest in bone
Leaves Bone to Bite
A = Soft, gentle, friendly, people motivated, solicitous, placid, inviting
B = Relaxed, friendly, raised paw, lip licking, solicitous, slightly more exuberant than an A dog, may appear apologetic if startled
C = Independent, maybe a bit rough, reactive, aroused, mouthy, exhibits some displacement such as sniffing, climbing
D = Stiffens, freezes, cautious, tentative, highly aroused, kinetic, serious, very rough (brutal), height seeking body checking
F = Lunging, snapping, combative, sustained eye contact, hard eye, tight mouth, bite attempt
For Intake History, record owner responses below.
Intake Hist.
Loves Children
Loves Dogs
Loves Cats
Loves Small Animals
No Medical Issues
Has / Will Lunge Or Show Aggression
Has / Will Attack Dogs
Has / Will Attack Cats
Has / Will Attack Sm. Animals
Medical Approval Required
Notes:
Customer Information:
Customer Name:
E-mail Address:
Home Address:
Home Phone:
3- Rev. August 2011
Cell Phone:
Other: