Equine Behavior History Form

Animal Behavior Consultants of Northern Michigan
Dr. Katherine A. Houpt
Phone: (989) 448-8083
web: http://abcofnm.com
email: kah@abcofnm.com

Please answer the following questions and submit this form. We shall then call to arrange an appointment. Specific questions about the problem behavior(s) will be asked during your visit/telephone call.

Main Behavior Problem

1. Chief complaint?
2. When did problem begin?
3. When does horse misbehave? How often and under what circumstances?
4. Has there been a change in the frequency of appearance of the problem?
5. What has been done so far to correct the problem?

Horse's Environment

1. Type of housing (stall, pasture, run-out shed)?
2. Diet?
3. Exercise (hrs per wk ridden, hrs per wk in paddock, type of bit used, martingale)?
4. Other horses in environment and relations between horses (friendly, aggressive, neutral)?
5. Other animals in environment?

Early History

1. Why was horse obtained? Is it still used for this purpose?
2. Source of animal?
3. Age at weaning?
4. Age when obtained by present owner?
5. Were there previous owners?
6. Do related horses have similar problems?

Education

1. Age at halter breaking?
2. Method of training to saddle or harness, age when training began?
3. Other types of training methods? driving jumping dressage games trail riding cutting

Other Behavior Problems

1. Shying, how often and at what? Any other phobias?
2. Head shy?
3. Resentful of grooming?
4. Aggression towards humans or animals (dogs, cows, etc.)?
5. Aggression toward other horses (threatens, strikes, bites, kicks, chases)?
6. Misbehavior under saddle (check appropriate behavior):
   moves while rider mounts
   backs in harness
   bucks
   rears
   wants to lead or will only follow other horses
   runs away
   slow to leave and quick to return to barn
   hard to keep on right or left
   other:
7. Barn vices (check appropriate one): cribs chews wood paws kicks stall
8. Sexual behavior: excessive, inadequate, abnormal?
9. Maternal behavior: excessive, inadequate, abnormal?

Physical History

1. Present medical problems?
2. Past medical problems?
3. Drug history?
4. Results of diagnostic tests?

(End of questionnaire, please submit - thank you!)

Submit Behavior Form