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

 
 
Response is required below.
Please enter a valid email address below.
Please enter valid phone number below.
Please select at least no options.
Please don't exceed more than options.
 

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.

Note: questions with asterisk (*) require an answer
Response is required below.
Please enter a valid email address below.
Please enter valid phone number below.
Please select at least no options.
Please don't exceed more than 0 options.
*
1. Full Name
Response is required below.
Please enter a valid email address below.
Please enter valid phone number below.
Please select at least no options.
Please don't exceed more than 0 options.
 
2. Home Address
Response is required below.
Please enter a valid email address below.
Please enter valid phone number below.
Please select at least no options.
Please don't exceed more than 0 options.
*
3. Telephone number
Response is required below.
Please enter a valid email address below.
Please enter valid phone number below.
Please select at least no options.
Please don't exceed more than 0 options.
*
4. Email address
Response is required below.
Please enter a valid email address below.
Please enter valid phone number below.
Please select at least options.
Please don't exceed more than options.
*
5. Gender
Response is required below.
Please enter a valid email address below.
Please enter valid phone number below.
Please select at least no options.
Please don't exceed more than 40 options.
*
6. Age 
Response is required below.
Please enter a valid email address below.
Please enter valid phone number below.
Please select at least no options.
Please don't exceed more than options.
 

Questions about your new dog

Note: questions with asterisk (*) require an answer
Response is required below.
Please enter a valid email address below.
Please enter valid phone number below.
Please select at least no options.
Please don't exceed more than 40 options.
*
1. Name of dog:
Response is required below.
Please enter a valid email address below.
Please enter valid phone number below.
Please select at least no options.
Please don't exceed more than 40 options.
*
2. Breed:
Response is required below.
Please enter a valid email address below.
Please enter valid phone number below.
Please select at least no options.
Please don't exceed more than 40 options.
*
3. Age:
Response is required below.
Please enter a valid email address below.
Please enter valid phone number below.
Please select at least no options.
Please don't exceed more than 0 options.
*
4. Does your dog need any special care?
Response is required below.
Please enter a valid email address below.
Please enter valid phone number below.
Please select at least no options.
Please don't exceed more than 40 options.
 
5. If yes, what is it?