New Client Questionnaire

1
Please note that our services are only available on a weekly recurring basis. Thank you for reaching out to tell us about you pup!
2
Contact Information* This field is required.This is used to set up your meet and greet, we will not spam you.
Your phone number
Your email address
Your first and last name
3
Address* This field is required.This is used to determine if you are in an area that we service. We service most of the Bethlehem area!
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
4
What services are you interested in?* This field is required.Please refer to our website for descriptions of these services
Pack Play - Only available on a recuring weekly basis
Boarding - Only available to Pack Play clients
Other
5
Desired Service Frequency* This field is required.
Regular ongoing schedule (ex., Mondays, Wednesdays, Fridays)
Seasonally
One time
Other
6
Desired Service Days* This field is required.Please enter accurately so we can check our availability for you!
Monday
Tuesday
Wednesday
Thursday
Friday
7
When will services begin?* This field is required.
8
When will services end? * This field is required.Please describe how long you would like our services and provide an end date if these services will not be ongoing.
9
How did you hear about us?Check all that apply
Instagram
Facebook
Google
Business Card
Referral (please tell us who in "other")
Other
10
The Basics* This field is required.All about your pet
Name
Breed
Intact female
Spayed female
Intact male
Neutered male
Sex
Age
Weight
Yes
No
Recently adopted?
Chronic health conditions or injuries?
11
What does your dog think of humans?* This field is required.
My dog thinks humans are the best thing ever, they will run right up to you
My dog loves humans but takes a few minutes to warm up
My dog likes humans but will need quite some time before they trust you
My dog is very nervous or shy with new people
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Behavior Questions* This field is required.
Yes
No
Unknown
Is your dog food aggressive with other animals or people?
No
Unknown, we don’t have a yard
Yes
Does your dog try to escape the yard?
All of the time
Most of the time
Half the time
When they feel like it
When I have treats
Hardly ever
How often does your dog listen to commands?
No
Yes
Unknown
Has your dog ever bitten a human or animal?
13
Behavioral Challenges* This field is required.Things that stress your pet out a lot or elicit undesirable responses - check all that apply
NONE OF THE BELOW
Being picked up
Collar being grasped (like while being leashed up)
Dogs in general or a specific type
Being left alone
Doorbells
Men
Strangers
Vacuums/mops/brooms
Medication administration
Loud vehicles and noises
Hats/uniforms
Being leashed
Car rides
Other
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Behavior Questions* This field is required.Behaviors your pet displays - check all that apply
NONE OF THE BELOW
Barking excessively during certain circumstances
Dominance over any human or other animals
Hyperactivity / Over-excitement
Pulling on the leash
Marking inside
Play biting
Fence jumping or escaping
Digging
Poor recall - runs away
Separation anxiety / clinginess
Jumping baby gates or fences
Stopping on the leash and refusing to walk
Guarding humans
Guarding toys
Guarding food
Other
15
Home Life* This field is required.
Where does your dog stay when home alone?
How long is your pet comfortable to be alone?
What time does your pet wake up & go to bed?
When does your pet eat their meals?
16
Dog Socialization * This field is required.
Yes
No
It depends
Unknown
Does your dog enjoy the company of dogs?
Yes
No
Has your dog ever been to doggy daycare?
Yes, often
Yes, but it has been a while
No
Do you take your dog to a dog park?
A lot
A little
Very little
Not at all
Unknown
My dog has been socialized with dogs...
17
Additional InformationUse this space to ask questions, tell us about your pet, or describe what your needs are! Please also tell us how many pets are in your home.
Huge
Large
Normal
Small
Ok
Ok
18
When can we meet you?Please pick a date as early as next week, same week meet and greets are not available. We care for pets full time so early morning and late afternoon appointments work best for us. We are closed on the weekends.
Date
Year
Month
Day
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Now what?

I will reach out soon to say hello and schedule a meet and greet! One thing I love about being an animal caregiver is that pets are family and families are SO unique. It is such an honor to provide our clients with the truly customized services that they deserve. Thank you for getting to know us and for telling us about you, we are greatful that you have considered Pack Pals to care for your furry family member. If we are not the right fit for you we will provide you with a wonderful recommendation to another pet care provider. Looking forward to chatting with you, tell your pet that Pack Pals says hello!

Warm Regards,

Abagail Giordano

Owner/Operator
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