Feedback

Data about the environment of the dog / dogs.

Personal data will be kept 100% confidential and will only be used to assess the overall situation.

You will also never be included in a mailing list because of this request.

Where do you live? *

Switzerland Liechtenstein Germany France Italy Belgium Netherlands Other

What Country? *

Language (multiple selection possible) *

English German Français

Name *

First name Last name

E-mail *

How would you like to be called back? *

Over phone Over a video call (WhatsApp, Skype, etc.)

Preferred contact over *

WhatsApp Signal Skype Does not matter

I have available *

WhatsApp Signal Skype

Skype-Id *

Phone no *

Country-Code Area code Number

Available *

Kommunikation (in unter "Hündelern" gewohnter) Du-Form? *

Ja, ist meine bevorzugte Wahl Ja, macht mir nichts aus Nein, ich würde lieber beim Sie bleiben

Family members (multiple selection) *

Single dog owner Partnership Teenagers over 12 years Children between 7-11 years Children under 7 years Infants up to 2 years Awaiting (birth in more than 3 months) Awaiting (birth in less than 3 months)

Living situation 1 *

in big city in agglomeration of big city small town in the country

Living situation 2 *

Block apartment Two-family house with fence Two-family house without fence One-family house with fence One-family house with garden but without fence other (please specify in remarks)

Would it be feasible for you to come to my center, would you like to show me your dog(s)? *

Yes, would like to come by Yes, maybe No, the way is too far No

When could you come to the center *

	in the morning	afternoon	later afternoon (after work)
Mo-Sa (immer)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

What time could you be at the center? *

Message / Comments *

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The most important information about your dog