New Client Questionnaire Name: Email: Name of Dog(s): What is your dog’s breed?: Which Facility?: Please select an optionDC/MD/NOVANYC/NJ/CT 1. How much time does/do your dog(s) spend in dog parks and/or socializing with other (non-family) dogs?: 4-6 hours/week 2-3 hours/week 1-2 hours/week Never 2. Is your dog a consistent and persistent loud barker?: YesNo 3. Has/have your dog(s) ever gotten into a fight with another dog where either was taken to a vet for an injury?: YesNo 4. Has/have your dog(s) ever bitten a person or acted aggressively toward a person?: YesNo 5. Is/are your dog(s) a full or mixed breed pit bull?: YesNo 6. Is/are your dog(s) neutered/spayed?: YesNo 7. Has/have your dog(s) ever scaled the equivalent of a 5′ fence and run away?: YesNo 8. Would you characterize your dog(s) as a potential escape risk? (For example, does she force herself through a crack in the door and dart outside?): YesNo 9. Is/are your dog(s) over 10 years of age?: YesNo 10. Does/do your dog(s) take special medication for a chronic injury or a debilitating condition? : YesNo 11. Which of the below best characterizes you as a dog owner? : “I am so in love with my dog. I think of her as my own child.” “I take great care of my dog but hold him accountable to his behavior.” “My friends/kids sometimes tease me by saying that my dog really rules the roost in our family.” 12. Does/do your dog(s) come to you when you call? : YesNo 13. Have you ever boarded your dog(s) before?: YesNo 14. Has/have your dog(s) ever been turned down for boarding or day care?: YesNo 15. Check any that apply: Neurotic Nervous Prone to fight Aggressive An escape artist Unpredictable Prone to severe skin reactions Prone to snap/bite Leash aggressive Acts abnormally during thunder/lightning storms Extremely reluctant to travel 16. Are you confident that your dog(s) will do well at our All-Season Boarding Campcamp?: Yes No I am not sure How did you find us?: Please select an optionGoogle (Sponsored Search)Google (Organic Search)YahooBingFacebookOther/Referral (see below) Other: Referral Name: Country Dogs Boarding Follow on Instagram Subscribe to Our Mailing List! Success! Name Email Subscribe! Country Dogs Boarding Follow on Instagram Subscribe to Our Mailing List! Success! Name Email Subscribe!
