You can always press Enter⏎ to continue
Welcome
Welcome
Thank you for your interest in our services! Please complete this form, it will take about three minutes. This helps us determine how we can best serve you! There are no such wrong answers!! ☺
19Questions
New Client Questionnaire
  • 1
    Press
    Enter
  • 2
    This is used to set up your meet and greet, we will not spam you.
    Press
    Enter
  • 3
    This is used to determine if you are in an area that we service. We service most of the Bethlehem area!
    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
    Press
    Enter
  • 4
    Please refer to our website for descriptions of these services
    Press
    Enter
  • 5
    Press
    Enter
  • 6
    Please enter accurately so we can check our availability for you!
    Press
    Enter
  • 7
    Press
    Enter
  • 8
    Please describe how long you would like our services and provide an end date if these services will not be ongoing.
    Press
    Enter
  • 9
    Check all that apply
    Press
    Enter
  • 10
    All about your pet
    • Intact female
    • Spayed female
    • Intact male
    • Neutered male
    • Yes
    • No
    Press
    Enter
  • 11
    Press
    Enter
  • 12
    • Yes
    • No
    • Unknown
    • No
    • Unknown, we don’t have a yard
    • Yes
    • All of the time
    • Most of the time
    • Half the time
    • When they feel like it
    • When I have treats
    • Hardly ever
    • No
    • Yes
    • Unknown
    Press
    Enter
  • 13
    Things that stress your pet out a lot or elicit undesirable responses - check all that apply
    Press
    Enter
  • 14
    Behaviors your pet displays - check all that apply
    Press
    Enter
  • 15
    Press
    Enter
  • 16
    • Yes
    • No
    • It depends
    • Unknown
    • Yes
    • No
    • Yes, often
    • Yes, but it has been a while
    • No
    • A lot
    • A little
    • Very little
    • Not at all
    • Unknown
    Press
    Enter
  • 17
    Use 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.
    TextSizeCreated with Sketch.
    • Huge
    • Large
    • Normal
    • Small
    BoldCreated with Sketch.
    ItalicCreated with Sketch.
    UnderlineCreated with Sketch.
    Underline CopyCreated with Sketch.
    Ok
    NumberList Copy 2Created with Sketch.
    quoteCreated with Sketch.
    BreakCreated with Sketch.
    ImageCreated with Sketch.
    Ok
    SmileyCreated with Sketch.
    Press
    Enter
  • 18
    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.
    -
    Pick a Date
    Press
    Enter
  • 19

    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

    Press
    Enter
  • Should be Empty:
JotForm Logo
Now create your own Jotform - It's free!Create your own Jotform
Question Label
1 of 19See AllGo Back
close