Separation Anxiety And Noise Phobia/Reactivity Questionnaire

The first set of these questions deals with an “actual absence”-the client actually leaves the house and the dog is either alone or totally without the client. The second set deals with “virtual absence”-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. Check NO if the dog does not react in the listed circumstance. Check UNKNOWN if you don’t know. Check YES if the dog reacts. Please evaluate the extent of the reaction from the list below.

IFYES:
100% of the time = always
< 100% of the time, but > 60% = more often than not
40%-60% of the time= about equally
0% of the time but < 40% = less often than not

1. Behaviors during an ACTUAL absence

2. Behaviors during a
VIRTUAL absence

3. Reactions to NOISE