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Behavioral Data Sheet - Equine
Instructions: The owner and/or trainer should fill out the forms giving as much relevant information as possible. While not all of this will appear to relate to your horse, completing the forms may disclose underlying problems that might otherwise be missed.
NAME & ADDRESS OF OWNER:
TELEPHONE: FAX: E-MAIL:
NAME & ADDRESS OF TRAINER:
TELEPHONE: FAX: E-MAIL:
NAME OF HORSE: BREED:
PRINCIPLE USE OF HORSE:
AGE OF HORSE NOW: AGE WHEN HORSE WAS OBTAINED:
ANY BEHAVIORAL CHANGES FOLLOWING GELDING/OVARIECTOMY?:
ANY MEDICAL PROBLEMS?:
ANY CURRENT MEDICATIONS: PLEASE GIVE DOSES IF KNOWN:
PERSON(S) ACCOMPANYING HORSE:
BEHAVIORAL PROBLEMS: If the horse has more than one problem please include information on each problem separately. Please answer as fully as possible.
Age of Onset:
Duration of each incident:
Frequency of occurrence:
Have there been any changes in the pattern, frequency, intensity and/or length of incidents from the time of onset to the present?:
Are there any specific conditions that trigger the behavior?
Can the horse be interrupted when engaged in the behavior?:
What is the time interval between the behavior stopping and resuming?
Describe any methods used to treat the behavior and the horse’s response to those methods:
Please use the above format to describe any other behavior problems the horse is having.
Where did you get the horse?
What was his/her former use if different from now?
Was horse obtained for a different purpose than his/her current use?
(Approximate) Number of former owners:
Do you know if related horses engage(d) in similar or other abnormal/unacceptable behaviors?
Type of housing (stall – standing or loosebox; pasture; run-in shed; round pen/small corral)
Hours and type of exercise each day:
Exercised every day?:
Hours of turn-out per day:
Type of bit used, martingale, other training aids:
Other horses with which horse interacts (list age, sex, type of contact):
Relationship between horses and other horses (friendly, aggressive, neutral):
Does horse attempt to herd others?:
Other animals in environment:
DIET: (How much and how often):
Age at weaning:
Broken to harness/saddle:
BEHAVIORAL PROBLEMS: (Describe where appropriate):
Shying -- how often and at what?
Head shy/resentful of grooming/handling:
Aggression towards humans or other animals:
Misbehavior under saddle:
Problems being led?:
Barn vices: (Circle where appropriate): cribbing wood chewing pawing kicking stall
windsucking flank chewing pacing circling refusal to tie
head bobbing weaving
Abnormal sexual behavior (excessive, inadequate, inappropriate):
Abnormal maternal behavior (excessive, inadequate, inappropriate):
Manure eating (coprophagia):
Please list all people who work with/ride horse. Include amount of time spent with horse and the type of work done. If a school horse level(s) of riding: