3. Why are you considering our off-leash dog play program for your dog? (check all that apply) ______ Play with other dogs ______So not home alone; check if exhibits symptoms of separation anxiety ______Exercise: Primary source or Additional source of exercise ? ______Recommended by other pet professional (trainer, vet, etc.); Reason: Other: 4. of the following best describes your dog’s level socialization with other dogs: None No knowledge of other dog interaction Minimal On leash encounters only □ – □ – Moderate Some off-leash playtime on occasion with visitor’s/neighbor’s/friend’s dog(s) □ – Extensive Regular visits to dog social events, off-leash dog parks, dog daycare, etc. □ – 5a. Has your dog had any problems previously in an off-leash social environment? No Yes, (check □ □ all that apply) Altercation or fight at a public dog park Altercation or fight with a neighbor or friend’s □ □ dog Fearful reaction in a group of dogs Dismissed from a prior dog daycare or social playgroup □ □ program (complete item 5b) Other (please describe) □ ____________________________________________ 5b. Only complete if you answered yes in 5a that your dog was dismissed from a prior program. What reason were you given as to why your dog was dismissed? Check each statement below that applies to the situation that resulted in your dog’s dismissal. ___ My dog was injured, no medical treatment required ___My dog was injured and required medical treatment ___Another dog was injured, no medical treatment required ___Another dog was injured and required medical treatment ___A person was injured, no medical treatment required ___A person injured and required medical treatment
3. Why are you considering our off-leash dog play program for your dog? (check all that apply) ______ Play with other dogs ______So not home alone; check if exhibits symptoms of separation anxiety ______Exercise: Primary source or Additional source of exercise ? ______Recommended by other pet professional (trainer, vet, etc.); Reason: Other: 4. of the following best describes your dog’s level socialization with other dogs: □ None – No knowledge of other dog interaction □ Minimal – On leash encounters only □ Moderate – Some off-leash playtime on occasion with visitor’s/neighbor’s/friend’s dog(s) □ Extensive – Regular visits to dog social events, off-leash dog parks, dog daycare, etc. 5a. Has your dog had any problems previously in an off-leash social environment? □ No □ Yes, (check all that apply) □ Altercation or fight at a public dog park □ Altercation or fight with a neighbor or friend’s dog □ Fearful reaction in a group of dogs □ Dismissed from a prior dog daycare or social playgroup program (complete item 5b) □ Other (please describe) ____________________________________________ 5b. Only complete if you answered yes in 5a that your dog was dismissed from a prior program. What reason were you given as to why your dog was dismissed? Check each statement below that applies to the situation that resulted in your dog’s dismissal. ___ My dog was injured, no medical treatment required ___My dog was injured and required medical treatment ___Another dog was injured, no medical treatment required ___Another dog was injured and required medical treatment ___A person was injured, no medical treatment required ___A person injured and required medical treatment
off-leash-play-application.docx