Questionnaire : Walk Your Dog project by Bastyr University (hosted by RASKC)

 
 
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Section 1. Demographics

This part of the questionnaire will help us understand the characteristic of the people participating in our program. All personal information is strictly confidential.

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1. Full Name
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2. Home Address
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3. Telephone number
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4. Email address
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5. Gender
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6. Age 
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Questions about your new dog

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1. Name of dog:
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2. Breed:
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3. Age:
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4. Does your dog need any special care?
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5. If yes, what is it?