Registration form

1
What is your name?* This field is required.
Dr.
Mr.
Mrs.
Miss.
Sir
Madam.
Dame.
Lord
Prefix
First Name
Last Name
2
Address?* This field is required.
Street Address
Street Address Line 2
City
Post code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
3
Phone Number?* This field is required.
Area Code
Phone Number
4
Email?
example@example.com
Confirm Email
5
What is the best way to contact you?* This field is required.
Email
Text
Call
6
How many dogs live with you?* This field is required.
1
2
3
4
5
7
What are their names?* This field is required.
8
What is your dogs age?* This field is required.
9
Breed* This field is required.please select the breed of your dog(s)
Affenpinscher
Afghan Hound
Airedale Terrier
Akita
Alaskan Klee Kai
Alaskan Malamute
American Bulldog
American English Coonhound
American Eskimo Dog
American Foxhound
American Pit Bull Terrier
American Staffordshire Terrier
American Water Spaniel
Anatolian Shepherd Dog
Appenzeller Sennenhunde
Australian Cattle Dog
Australian Kelpie
Australian Shepherd
Australian Terrier
Azawakh
Barbet
Basenji
Basset Hound
Beagle
Bearded Collie
Bedlington Terrier
Belgian Malinois
Belgian Sheepdog
Belgian Tervuren
Berger Picard
Bernedoodle
Bernese Mountain
Bichon Frise
Black and Tan Coonhound
Black Mouth Cur
Black Russian Terrier
Bloodhound
Blue Lacy
Bluetick Coonhound
BoerboelBoerboel
Bolognese
Border Collie
Border Terrier
Borzoi
Boston Terrier
Bouvier des Flandres
Boxer
Boykin Spaniel
Bracco Italiano
Briard
Brittany
Brussels Griffon
Bull Terrier
Bulldog
Bullmastiff
Cairn Terrier
Canaan Dog
Cane Corso
Cardigan Welsh Corgi
Catahoula Leopard Dog
Caucasian Shepherd Dog
Cavalier King Charles Spaniel
Cesky Terrier
Chesapeake Bay Retriever
Chihuahua
Chinese Crested
Chinese Shar-Pei
Chinook
Chow Chow
Clumber Spaniel
Cockapoo
Cocker Spaniel
Collie
Coton de Tulear
Curly-Coated Retriever
Dachshund
Dalmatian
Dandie Dinmont Terrier
Doberman Pinscher
Dogo Argentino
Dogue de Bordeaux
Dutch Shepherd
English Cocker Spaniel
English Foxhound
English Setter
English Springer Spaniel
English Toy Spaniel
Entlebucher Mountain Dog
Field Spaniel
Finnish Lapphund
Finnish Spitz
Flat-Coated Retriever
Fox Terrier
French Bulldog
German Pinscher
German Shepherd Dog
German Shorthaired Pointer
German Wirehaired Pointer
Giant Schnauzer
Glen of Imaal Terrier
Goldador
Golden Retriever
Goldendoodle
Gordon Setter
Great Dane
Great Pyrenees
Greater Swiss Mountain Dog
Greyhound
Harrier
Havanese
Ibizan Hound
Icelandic Sheepdog
Irish Red and White Setter
Irish Setter
Irish Terrier
Irish Water Spaniel
Irish Wolfhound
Italian Greyhound
Jack Russell Terrier
Japanese Chin
Japanese Spitz
Korean Jindo Dog
Karelian Bear Dog
Keeshond
Kerry Blue Terrier
Komondor
Kooikerhondje
Kuvasz
Labradoodle
Labrador Retriever
Lagotto Romagnolo
Lakeland Terrier
Lancashire Heeler
Leonberger
Lhasa Apso
Lowchen
Maltese
Maltese Shih Tzu
Maltipoo
Manchester Terrier
Mastiff
Miniature Pinscher
Miniature Schnauzer
Mudi
Mixed Breed
Neapolitan Mastiff
Newfoundland
Norfolk Terrier
Norwegian Buhund
Norwegian Elkhound
Norwegian Lundehund
Norwich Terrier
Nova Scotia Duck Tolling Retriever
Old English Sheepdog
Otterhound
Papillon
Peekapoo
Pekingese
Pembroke Welsh Corgi
Petit Basset
Pharaoh Hound
Plott
Pocket Beagle
PointerPointer
Polish Lowland Sheepdog
Pomeranian
Pomsky
Poodle
Portuguese Water Dog
Pug
Puggle
Puli
Pyrenean Shepherd
Rat Terrier
Redbone Coonhound
Rhodesian Ridgeback
Rottweiler
Saint Bernard
Saluki
Samoyed
Schipperke
Schnoodle
Scottish Deerhound
Scottish Terrier
Sealyham Terrier
Shetland Sheepdog
Shiba Inu
Shih Tzu
Siberian Husky
Silken Windhound
Silky Terrier
Skye Terrier
Sloughi
Small Munsterlander Pointer
Soft Coated Wheaten Terrier
Stabyhoun
Staffordshire Bull Terrier
Standard Schnauzer
Sussex Spaniel
Swedish Vallhund
Tibetan Mastiff
Tibetan Spaniel
Tibetan Terrier
Toy Fox Terrier
Treeing Tennessee Brindle
Treeing Walker Coonhound
Vizsla
Weimaraner
Welsh Springer Spaniel
Welsh Terrier
West Highland White Terrier
Whippet
Wirehaired Pointing Griffon
Xoloitzcuintli
Yorkipoo
10
Up to date on vaccination?* This field is required.
Yes
No
11
We cannot service dogs that haven't been Spayed or Neutered

(unless you need a private walk)

Puppies will need to be spayed or neutered

before turning 1
12
Are your dog(s) Spayed/ Neutered* This field is required.
YESNO
13
Have a microchip?* This field is required.You are required by law to microchip your dogs
YESNO
14
Are your dogs insured?We highly recommend insuring all pets. Medical expenses often cost thousands of pounds!
YESNO
15
Who are you insured with?* This field is required.We highly recommend you insure all pets. Medical expenses often cost thousands of pounds!
16
What is the address of your register Vet?* This field is required.Please let us know your registered veterinary practice
17
Do you have in-home security camera's?* This field is required.
YESNO
18
Does your home have an alarm system?* This field is required.If Yes. Please write your alarm code in your client portal.
YESNO
19
Will there be anyone in your home, on a daily basis when we pick up or drop off your dog(s)?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
20
Is there any part of your home, your dog isn't allowed to be in?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
21
Where would you like us to leave your dog in your house? * This field is required.Please let us know if you would like your dog to be shut into any rooms or if they can wonder around freely
Huge
Large
Normal
Small
Ok
Ok
22
Does your dog need to be crated whilst you're away?* This field is required.
YESNO
23
Does your dog have a favourite place to hide in your home?* This field is required.
24
Does your dog(s) pull on the walks?* This field is required.
YESNO
25
Are you attending any training classes with your dog(s)?* This field is required.
Yes
No
What reason are you attending training classes?
26
Are there any areas in your home your dog becomes territorial over?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
27
How would you typically describe your dogs personality?* This field is required.
Extremely nervous
Nervous
Easily scared
Dominate
Submissive
Sweet
Happy
Calm
Anxious
Excited
Territorial
Stubborn
Vocal
Friendly
Independent
28
Has your dog ever snapped at yourself or any others (including pets) over food or toys?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
29
How does your dog behave around* This field is required.See below
Children?
Cats?
Small animals?
30
How does your dog behave around other dogs? * This field is required.
Huge
Large
Normal
Small
Ok
Ok
31
Will your dog(s) need to wear a muzzle during walks?* This field is required.
32
Are your dog(s) housetrained?* This field is required.
YESNO
33
How long can you leave your dog alone?* This field is required.
My dog can't be left alone
Less than an hour
One hour
Two hours
Three hours
More
34
Does your dog(s) suffer from car sickness?* This field is required.
YESNO
35
Has your dog(s) ever done the following risky behaviours?* This field is required.
Run out of an open door or gate
Refused to come when you called
Stolen food from strangers
Ran away from you
Ran home on their own
Bitten you
Bitten another dog
Excessively barks in the car
Steals toys from others
Scavenge for food
Started a fight
Frequently gets into fights
Killed another animal (including another dog)
Been aggressive towards strangers
Destroyed furniture or clothing
None of the above
36
If you answered yes to any of the previous questions, please explain the situations the incidents happened in * This field is required.
Huge
Large
Normal
Small
Ok
Ok
37
As a result of risky behaviour, have you ever had take your dog(s) to the vet in an emergency?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
38
Which services are you interested in?* This field is required.
Dog walk in a group
Dog walk in private
Daycare all day
Half daycare
Boarding
39
What time would you like dog walks to begin* This field is required.We walk dogs between 9-10am 11-2pm 3-5pm
1
2
3
4
5
6
7
8
9
10
11
12
Hour
00
10
20
30
40
50
Minutes
AM
AM
PM
40
Where do you keep your dog supplies such as leads and collars?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
41
How did you hear about us?* This field is required.
Google
Groomers
Bing
Blog
Facebook
Instagram
Newspaper
Through a friend
Dog walker working in Pups Go Walking
Youtube
Yell
Vet
42
Is there any other important information we should know?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
43
Please confirm the information you have given, is to the best of your knowledge* This field is required.
Yes. I confirm I have answered all questions truthfully
44
Would you like to receive further emails from us? such as newsletters and feedback forms* This field is required.
YESNO
45
Newsletter
Yes, subscribe me to this newsletter
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