Name
First Name
Last Name
Dog's Name
Why are you considering NEST playcare for your dog? (Check all that apply)
*
I want my dog to socialize with other dogs
I don't want my dog to be home alone
My dog has separation anxiety
This will be my dog's primary source of exercise
This will be an additional source of exercise for my dog
It was recommended by other pet professional (trainer, vet, etc)
Other
Playcare Behavior Questionnaire
If you selected "Other" or "recommended by another pet professional" please provide more detail.
What knowledge do you have of your dog’s history?
*
Which of the following best describes your dog’s level of socialization with other dogs?
*
Please Select
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.
How would you describe the energy level of your dog?
*
Please Select
Low
Medium
High
I'm unsure which best fits my dog
Check the box below that best represents your dog’s overall level of exercise routine:
*
Couch Potato: spends days sleeping, occasional walks and/or playtime with humans or dogs
Mild Player: short daily walks and/or regular playtime with human or dogs
Moderate Player: long or multiple walks daily and/or regular playtime with human or dogs
Athlete: regular jogs/runs and/or regular participation in a dog sport activity such as agility, hiking, frisbee, etc.
How did your dog obtain his/her obedience training? (Please check all that apply)
Attended one group class
Attended more than one level of group classes (beginner and intermediate, etc.)
Dog was sent to a board and train program
Private lessons in home
Dog has never had formal obedience training
Which obedience commands or tricks does your dog know well? Please describe:
Which of the following best describes the use of obedience cues with your dog at home?
*
Please Select
Key part of daily communication
Used when we go on walks or have people over
Used occasionally to better control behavior
Rarely used
Not applicable
Select any problems your dog has previously had in an off-leash social environment.
*
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
Other
Not applicable
If you selected "other", please describe
If your dog was dismissed from a prior program: What reason were you given for their dismissal? Please provide as much detail as possible so we can better understand your pup.
What kind of toys does your dog like to play with?
*
Has your dog ever shared food or toys with other dogs?
*
Yes
No
If yes, how does your dog react to another dog or person approaching his/her food or toys?
Are there any breeds, energy levels, or ages of dogs your dog seems to be uncomfortable with?
Yes
No
If yes, please explain:
Has your dog ever had a negative reaction toward cats or other small animals?
*
Yes
No
If yes, please explain the circumstances:
What does your dog do to show they are happy?
*
What does your dog do to show they are upset or uncomfortable?
*
Please provide any additional comments or information about your dog that you feel might be helpful:
Thank you for the time you spent completing the questionnaire. We look forward to meeting you and your dog on the scheduled meet & greet day. Please contact us if you have any questions on the next steps of the meet and greet process.
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