CALL US:

804-795-9415

2610 Shadewood Lane

Charles City, VA 23030

New Pet Questionnaire
without Group Play

A Stay in the Country Pet Lodge and Training Center

Please complete this questionnaire fully — one form per dog.

    Owner Information

    Dog Information

    (One form per dog)


    SpayNeuteredIntact


    MF

    (Check all that apply)

    DAYCAREBOARDINGGROOMING

    HEALTH & CARE


    YesNo

    HANDLING & COMFORT


    ComfortableSlightly nervousVery nervousDefensive


    FeetEarsMouthTailGroomingHarness/CollarOther



    ComfortableWhines/BarksPacesStress signsUnknown

    PEOPLE, WALKING & SAFETY


    FriendlyReservedNervousProtective


    NoYes


    Flat collarHarnessHead collarOther



    Loose leashPullsReactive to dogsReactive to people


    NoYes

    STRESS & ENRICHMENT


    NoYes

    (check all that apply)
    WalksOne-on-one playToysTreat puzzlesQuiet rest time


    Small BlanketToysOwner clothing/T-ShirtNone

    FINAL NOTES