Your Name
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First Name
Last Name
Email
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Phone
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(###)
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Dog's Name
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Respite Start Date
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MM
DD
YYYY
Respite End Date
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MM
DD
YYYY
How did the dog behave in the house generally?
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Please check any of the below behaviors if observed.
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If yes to any of the above, please explain.
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Did the dog adjust to the new household and seem comfortable? If no, please explain
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How did the dog behave when meeting people?
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Did the dog exhibit any reactivity or signs of stress? If so, please explain.
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If yes, to the above questions, what did you do to support the dog?
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Did the dog pull on leash? If so, towards anything specific or just in general? How did you handle this?
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Was the dog able to follow cues? If not, please explain
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How did the dog behave when left alone? (eg. in crate at night, or when you left the house)?
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How did the dog act around children, dogs, cats, or other animals?
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Did the dog have any health problems? If yes, please explain
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Did the dog have trouble getting in or out of the car? If yes, please explain.
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How did the dog behave in the car? (eg. crossing barrier, barking, whining)
Please provide any feedback that you think would be beneficial to us.
Based on the survey you were given before you got the dog, were there any surprises in the dog’s behavior?
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Woud you provide respite for this dog again?
