East Lake Day Camp Questionnaire
Please answer the following questions before enrolling your pet in Day Camp activities.
1. What does your dog do when you take away a full food bowl?
Wags Tail Becomes Aggressive Walks Away Barks Lays Down Licks You Growls Not Sure Other (below)
2. What is your dog's behavior when you walk him by other dogs?
Aggressive Submissive Ignores Wags Tail Wants to Play Not Sure Other (below)
3. 3. Does your dog get along better with small , or large dogs? Male or female?
4. How would you describe your dog’s behavior?
Fearful Submissive/Shy Playful/Friendly Aggressive/Assertive Inactive Not Sure Happy Outgoing Other (below)
5: Does your dog like to play in water? Yes No Not Sure
6. What are some of your dog’s favorite things to play with or do?
Balls Toys People Other Dogs Water Sand Digging Frisbee Not Sure Other (below)
7. What is your dog’s behavior when you walk him/her by other dogs?
Completely at Ease Aggressive Growls Lunges Anxious Submissive Bites/Nips Wags Tail Jumps Barks Tries to Hump Not Sure Other (Below)
8. What is your dog’s behavior during a veterinary examination?
Completely at Ease Aggressive Growls Lunges Anxious Submissive Bites/Nips Wags Tail Jumps Barks Not Sure Other (Below)
9. My dog is sensitive about his/her: Feet Mouth Nose Nails Ears Face Tail Back/Hips Not Sensitive Not Sure Other (Below)
10. What is your dog’s behavior when you put him/her on a leash? Walks Well Pulls Won’t Move Jumps Bites/Nips Chews Leash Carries Leash Resists Leash Not Sure Other (below)
11. What is your dog’s behavior when he/she is taken into a new environment with other people? Submissive Friendly Aggressive No Change Not Sure Other (below)
12. Is your dog already trained with basic commands?
Yes? No? Unsure?
What commands do you use? (check all that apply) Sit? Stay? Come No Comands Other Commands (below)
13. Is your dog house trained?
Yes No Not Sure
14. Does he/she wait until walks to urinate/defecate?
15. Does your dog ever appear fearful?
Yes No Not Sure (if yes is checked, please explain below)
16. Does your dog have a preference to male or female people?
My dog prefers male people. My dog prefers female people. My dog shows no preference for males or females.
17. Does your dog have thunderstorm anxiety?
(If yes is checked above, is he/she on medication? Yes No what? (list below)
18. Does your dog have separation anxiety?
19. Has your dog ever bitten a person?
Yes No (if yes is checked, please explain below)
20. Has your dog ever bitten another animal?
21. Does your dog spend more time: Inside Outside
22. Has your dog had any past injuries/illness/allergies we should be aware of?
23. Has your dog ever exhibited “cage or kennel aggression” or “territory aggression”?
24. Is your pet currently on medication(s)? If so, what? (list below)
25. Please share with us any additional information you think we should know
26: Do you already have camp scheduled? If so what day(s)?
Your pet's name: Your name: Street Address: City: State: Zip: Home phone: Work Phone: e-mail:
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