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1. Do you own a dog(s) or have you owned one in the past?
2. If yes, what breed(s) or mix of breeds was your dog(s)?
3. What size is the dog(s)? Small up to 20 pounds, medium 20 to 50 pounds, large 50 to 100 pounds or extra large over 100 pounds
4. Has your dog(s) ever nipped, bitten or attacked anyone?
Yes, nipped
Yes, bit
Yes, attacked
No
5. If yes, what breed(s) or mix of breeds was the dog(s) that nipped, bit or attacked? Was it a purebred? If not are you sure of the mix? Please Explain
6. What were the circumstances of the nip, bite or attack(s)?
7. Do you personally know of another dog(s) who has nipped, bitten or attacked a human? Please do not include stories from news reports. This question refers to dogs you personally know or a human you personally know who has been nipped, bitten or attacked.
8. If yes, who did the other dog(s) nip, bite or attack?
9.What breed(s) or mix of breeds was the other dog(s) that nipped, bit or attacked? Was it a purebred? If not are you sure of the mix? Please Explain
10. What size was the other dog(s)? Small up to 20 pounds, medium 20 to 50 pounds, large 50 to 100 pounds or extra large over 100 pounds
11. What were the circumstances of the other dog(s) nip, bite or attack(s)?
12. Are you afraid of dogs?
Yes, very afraid
Yes, a little afraid
Depends on the dog
13. Where are you from?
14. Your Name
15. Your Email Address
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