Training Survey - Chucktown Charley

Welcome to the First Step in Transforming Your Dog’s Life

At Chucktown Charley, we believe every dog is unique, and we’re here to help you unlock the full potential of your beloved companion.

Our training approach is unlike any other. We employ Training Between The Ears (TBTE) techniques that prioritize reward and relaxation strategies over traditional command-based training. We address your dog’s emotional state to create meaningful, lasting changes, helping your dog feel calm, confident, and resilient in any situation.

Why Choose Chucktown Charley?

⭐ A Stronger Bond: We focus on building trust and connection between you and your dog, making training a joyful and harmonious journey.

⭐ Freedom of Choice: Instead of micromanaging, we teach your dog to make great choices independently, which reduces stress for both of you.

⭐ Learning Through Play: With fun, interactive games, your dog learns valuable life skills while having the time of their life.

Our programs are results-focused, lasting at least four weeks, and customized to your dog’s personality and needs. From socialization to relaxation techniques and confidence-building skills, we’re here to guide you every step of the way.

Your Role in the Journey:

Your participation is key to your dog’s success! The first step in this exciting adventure is filling out our behavioral survey.

By taking a few moments to complete the survey, you’ll help us:

Understand your dog’s unique needs and challenges.
Tailor a program that addresses your goals.
Make your Discovery Session as valuable and productive as possible.

The more details you share, the better we can prepare to support you and your dog.

DOG BEHAVIORAL SURVEY

your journey to a happier dog starts here

Today's Date*
MM slash DD slash YYYY
Owner Name:*
First Last
Phone Number:*
Email:*
Address*
ZIP / Postal Code
Preferred Communication Method:*
- Email
- Phone- Text
I am interested in:*
- Day Train at Chucktown Charley
- Board and Train at Chucktown Charley
- Playcare and Lodging Orientation Program
- All of the Above
How did you hear about us?*
- Referred by Rescue Organization/ Shelter
- Referred by a Friend
- Referred by a Veterinarian
- Internet Search
- Facebook/ Instagram/ Youtube/ Other Social Media
Who may we thank for your referral?
Number of Adults in the Household*
Number of Children in the Household*
First Child Age
Second Child Age
Third Child Age
Fourth Child Age
Fifth Child Age
We’d love to get to know your dog(s)! Please be as detailed as possible in your responses—there are no right or wrong answers, and this is a judgment-free zone. If you haven’t brought your puppy home yet, fill out what you can. Your honesty and insights help us create the best training experience for you and your dog(s).
This field is hidden when viewing the form
How many dogs in the home?*
How many dogs in the home?*
- 1
- 2
- 3
Dog's Name:
First Dog's Name:
Second Dog's Name:
Third Dog's Name:
Dog's Life Stage*
- Younger than 6 months
- Older than 6 months
Dog's Age:*
First Dog's Life Stage:*
- Younger than 6 months
- Older than 6 months
First Dog's Age:*
Second Dog's Life Stage:*
- Younger than 6 months
- Older than 6 months
Second Dog's Age:*
Third Dog's Life Stage*
- Younger than 6 months
- Older than 6 months
Third Dog's Age:*
Dog's Breed:
First Dog's Breed:
Second Dog's Breed:
Third Dog's Breed:
How long have you had the dog?
How long have you had the first dog?
How long have you had the second dog?
How long have you had the third dog?
How did you obtain your dog?
- Breeder
- Rescue/ Shelter
- From a Friend
How did you obtain your first dog?
- Breeder
- Rescue/ Shelter
- From a Friend
How did you obtain your second dog?
- Breeder
- Rescue/ Shelter
- From a Friend
How did you obtain your third dog?
- Breeder
- Rescue/ Shelter
- From a Friend
Which one?
How old was your dog when you brought them home?
How old was your first dog when you brought them home?
How old was your second dog when you brought them home?
How old was your third dog when you brought them home?
How old was the dog when he/she left the litter?
How old was the first dog when he/she left the litter?
How old was the second dog when he/she left the litter?
How old was the third dog when he/she left the litter?
How did you select your puppy?
- Breeder Selected
- Breeder temperament test- puppy suited my needs
- Looks
- Smallest
- Biggest
- Most outgoing
- Most quiet/ calm
- Most timid
- Most affectionate
- Only pup left from the litter
- Other
- N/A Acquired dog as an adult
If you got your dog as a puppy (younger than 6 months), how did you select your puppy?
- Breeder Selected
- Breeder temperament test- puppy suited my needs
- Looks
- Smallest
- Biggest
- Most outgoing
- Most quiet/ calm
- Most timid
- Most affectionate
- Only pup left from the litter
- Other
- N/A Acquired dog as an adult
If you got your first dog as a puppy (younger than 6 months), how did you select your puppy?
- Breeder Selected
- Breeder temperament test- puppy suited my needs
- Looks
- Smallest
- Biggest
- Most outgoing
- Most quiet/ calm
- Most timid
- Most affectionate
- Only pup left from the litter
- Other
- N/A Acquired dog as an adult
If you got your second dog as a puppy (younger than 6 months), how did you select your puppy?
- Breeder Selected
- Breeder temperament test- puppy suited my needs
- Looks
- Smallest
- Biggest
- Most outgoing
- Most quiet/ calm
- Most timid
- Most affectionate
- Only pup left from the litter
- Other
- N/A Acquired dog as an adult
If you got your third dog as a puppy (younger than 6 months), how did you select your puppy?
- Breeder Selected
- Breeder temperament test- puppy suited my needs
- Looks
- Smallest
- Biggest
- Most outgoing
- Most quiet/ calm
- Most timid
- Most affectionate
- Only pup left from the litter
- Other
- N/A Acquired dog as an adult
How did you select your first puppy?
- Breeder Selected
- Breeder temperament test- puppy suited my needs
- Looks
- Smallest
- Biggest
- Most outgoing
- Most quiet/ calm
- Most timid
- Most affectionate
- Only pup left from the litter
- Other
- N/A Acquired dog as an adult
How did you select your second puppy?
- Breeder Selected
- Breeder temperament test- puppy suited my needs
- Looks
- Smallest
- Biggest
- Most outgoing
- Most quiet/ calm
- Most timid
- Most affectionate
- Only pup left from the litter
- Other
- N/A Acquired dog as an adult
How did you select your third puppy?
- Breeder Selected
- Breeder temperament test- puppy suited my needs
- Looks
- Smallest
- Biggest
- Most outgoing
- Most quiet/ calm
- Most timid
- Most affectionate
- Only pup left from the litter
- Other
- N/A Acquired dog as an adult
What is the reason you chose to get a dog?
Veterinarian's Name*
Veterinarian's Phone
Is your dog*
- Male
- Female
- Spayed Female
- Neutered Male
Is your first dog*
- Male
- Female
- Spayed Female
- Neutered Male
Is your second dog*
- Male
- Female
- Spayed Female
- Neutered Male
Is your third dog*
- Male
- Female
- Spayed Female
- Neutered Male
Are there any medical issues for your dog that you are aware of? Any food allergies?
Are there any medical issues for your first dog that you are aware of? Any food allergies?
Are there any medical issues for your second dog that you are aware of? Any food allergies?
Are there any medical issues for your third dog that you are aware of? Any food allergies?
What brand AND amount of food are you feeding your dog per day? How many times per day?
What brand AND amount of food are you feeding your first dog per day? How many times per day?
What brand AND amount of food are you feeding your second dog per day? How many times per day?
What brand AND amount of food are you feeding your third dog per day? How many times per day?
How is your dog fed? Free-fed, fed on a schedule, in crates, etc.
How are your dogs fed? Free-fed, fed on a schedule, in crates, etc.
Where does your dog sleep at night?
- Crated
- Outside Pen
- Human's Bed
- Garage
Where do your dogs sleep at night?
- Crated
- Outside Pen
- Human's Bed
- Garage
How much sleep does your dog currently get every 24 hours?
Where is your dog kept when left alone?
Where are your dogs kept when left alone?
Is your dog crate trained?*
- Yes
- No
Please describe in detail how your dog(s) reacted in the crate.*
Has your dog or have your dogs ever harmed themselves a crate?*
- Yes
- No
Please explain.*
Is your first dog crate trained?*
- Yes
- No
Is your second dog crate trained?*
- Yes
- No
Is your third dog crate trained?*
- Yes
- No
If your dogs are not crate trained, are you interested in crate training?*
- Yes
- No
If your dog is not crate trained, are you interested in crate training?*
- Yes
- No
What is or will be your dog's primary form of exercise?
What are or will be your dogs' primary form of exercise?
How much exercise does your dog currently get?
How much exercise do your dogs currently get?
How consistent is this exercise?
What is your living situation?
- House
- Apartment/Condo
Do you have a fenced in yard?
- Yes
- No
Do you plan on leaving your dog(s) unattended in your backyard?
- Yes
- No
Have you done any previous training on your own? Be as specific as you can about the methods used, level of success, etc.
Have you done any previous training with another trainer (even if it was with another dog)? Be as specific as you can about the type of training, level of success, what you liked, what you did not like, etc.
Does your dog attend daycare or boarding at a facility?*
- Daycare or Boarding at Chucktown Charley
- Daycare or Boarding at Another Facility
- Does not currently attend daycare or boarding
- Has never attended daycare or boarding
Do your dogs attend daycare or boarding at a facility?*
- Daycare or Boarding at Chucktown Charley
- Daycare or Boarding at Another Facility
- Do not currently attend daycare or boarding
- Have never attended daycare or boarding
Which facility or facilities?*
Has your dog had any socialization or exposure to people, other dogs, or both? If so, please provide more details.
Have your dogs had any socialization or exposure to people, other dogs, or both? If so, please provide more details.
How often do you walk your dog?
How often do you walk your first dog?
How often do you walk your second dog?
How often do you walk your third dog?
Does your dog pull on the leash?
- Yes. All the time.
- Sometimes.
- No. Walks nicely on the leash.
- Dog is not walked.
Does your first dog pull on the leash?
- Yes. All the time.
- Sometimes.
- No. Walks nicely on the leash.
- Dog is not walked.
Does your second dog pull on the leash?
- Yes. All the time.
- Sometimes.
- No. Walks nicely on the leash.
- Dog is not walked.
Does your third dog pull on the leash?
- Yes. All the time.
- Sometimes.
- No. Walks nicely on the leash.
- Dog is not walked.
Dog is walked using:
- Flat collar
- Off leash
- Retractable leash
- Harness
- Headcollar
- Slip collar/ choke chain
- Prong collar
- E-collar
- Dog is not walked
- Other
First Dog is walked using:
- Flat collar
- Off leash
- Retractable leash
- Harness
- Headcollar
- Slip collar/ choke chain
- Prong collar
- E-collar
- Dog is not walked
- Other
Second Dog is walked using:
- Flat collar
- Off leash
- Retractable leash
- Harness
- Headcollar
- Slip collar/ choke chain
- Prong collar
- E-collar
- Dog is not walked
- Other
Third Dog is walked using:
- Flat collar
- Off leash
- Retractable leash
- Harness
- Headcollar
- Slip collar/ choke chain
- Prong collar
- E-collar
- Dog is not walked
- Other
Please specify what tool you use.
What physical limitations do you have that I should be aware of (i.e. difficulty bending, holding a leash, maintaining balance)?
How does your puppy react to sudden noises?
How do your puppies react to sudden noises?
Does your puppy or do your puppies enjoy playing with toys?
How often does your puppy play bite?
- Does not display this behavior
- Infrequently
- All the time
How often does your first puppy play bite?
- Does not display this behavior
- Infrequently
- All the time
How often does your second puppy play bite?
- Does not display this behavior
- Infrequently
- All the time
How often does your third puppy play bite?
- Does not display this behavior
- Infrequently
- All the time
If your puppy is pottying in the house, how often does it happen?
- Does not potty in the house
- Infrequently (less than 3 times a week)
- Occasionally (3-5 times a week)
- Almost every day
- Daily
- Several times per day
If your first puppy is pottying in the house, how often does it happen?
- Does not potty in the house
- Infrequently (less than 3 times a week)
- Occasionally (3-5 times a week)
- Almost every day
- Daily
- Several times per day
If your second puppy is pottying in the house, how often does it happen?
- Does not potty in the house
- Infrequently (less than 3 times a week)
- Occasionally (3-5 times a week)
- Almost every day
- Daily
- Several times a day
If your third puppy is pottying in the house, how often does it happen?
- Does not potty in the house
- Infrequently (less than 3 times a week)
- Occasionally (3-5 times a week)
- Almost every day
- Daily
- Several times a day
Has your puppy exhibited any growling, lip snarling, stiffening behaviors? If so, please explain in detail.
Have your puppies exhibited any growling, lip snarling, stiffening behaviors? If so, please explain in detail.
Describe in detail how your dog reacts to the site of another animal when they are on leash.
Describe in detail how your first dog reacts to the site of another animal when they are on leash.
Describe in detail how your second dog reacts to the site of another animal when they are on leash.
Describe in detail how your third dog reacts to the site of another animal when they are on leash.
Describe in detail how your dog reacts to the site of another human when they are on leash.
Describe in detail how your first dog reacts to the site of another human when they are on leash.
Describe in detail how your second dog reacts to the site of another human when they are on leash.
Describe in detail how your third dog reacts to the site of another human when they are on leash.
Describe in detail how your dog reacts to the site of another animal when they are off leash.
Describe in detail how your first dog reacts to the site of another animal when they are off leash.
Describe in detail how your second dog reacts to the site of another animal when they are off leash.
Describe in detail how your third dog reacts to the site of another animal when they are off leash.
Describe in detail how your dog reacts to the site of another human when they are off leash.
Describe in detail how your first dog reacts to the site of another human when they are off leash.
Describe in detail how your second dog reacts to the site of another human when they are off leash.
Describe in detail how your third dog reacts to the site of another human when they are off leash.
Has your dog ever gotten into a dog fight or bitten a person?
- Has not bitten
- Has bitten another dog
- Has been in a full- on dog fight
- Has nipped a person- no broken skin
- Has bitten a person- broken skin
Has your first dog ever gotten into a dog fight or bitten a person?
- Has not bitten
- Has bitten another dog
- Has been in a full- on dog fight
- Has nipped a person- no broken skin
- Has bitten a person- broken skin
Has your second dog ever gotten into a dog fight or bitten a person?
- Has not bitten
- Has bitten another dog
- Has been in a full- on dog fight
- Has nipped a person- no broken skin
- Has bitten a person- broken skin
Has your third dog ever gotten into a dog fight or bitten a person?
- Has not bitten
- Has bitten another dog
- Has been in a full- on dog fight
- Has nipped a person- no broken skin
- Has bitten a person- broken skin
In the last 3 months, how many times has your dog threatened to bite a human (air snaps, growling, lifted lip) but has not made skin contact?
- Has not threatened to bite or shown any of the listed behaviors
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
In the last 3 months, how many times has your first dog threatened to bite a human (air snaps, growling, lifted lip) but has not made skin contact?
- Has not threatened to bite or shown any of the listed behaviors
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
In the last 3 months, how many times has your second dog threatened to bite a human (air snaps, growling, lifted lip) but has not made skin contact?
- Has not threatened to bite or shown any of the listed behaviors
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
In the last 3 months, how many times has your third dog threatened to bite a human (air snaps, growling, lifted lip) but has not made skin contact?
- Has not threatened to bite or shown any of the listed behaviors
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
In the last 3 months, how many times has your dog “nipped”- made human skin contact with teeth but did no damage?
- Has not nipped
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
In the last 3 months, how many times has your first dog “nipped”- made human skin contact with teeth but did no damage?
- Has not nipped
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
In the last 3 months, how many times has your second dog “nipped”- made human skin contact with teeth but did no damage?
- Has not nipped
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
In the last 3 months, how many times has your third dog “nipped”- made human skin contact with teeth but did no damage?
- Has not nipped
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
In the last 3 months, how many times has your dog made contact with human skin and did minor damage (1-4 punctures, dog did not hold on)?
- Has not nipped
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
In the last 3 months, how many times has your first dog made contact with human skin and did minor damage (1-4 punctures, dog did not hold on)?
- Has not nipped
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
In the last 3 months, how many times has your second dog made contact with human skin and did minor damage (1-4 punctures, dog did not hold on)?
- Has not nipped
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
In the last 3 months, how many times has your third dog made contact with human skin and did minor damage (1-4 punctures, dog did not hold on)?
- Has not nipped
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
In the last 3 months, how many times has your dog bitten a human and caused deep punctures, bruising, or damage caused by holding onto the bite?
- Has not bitten
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
In the last 3 months, how many times has your first dog bitten a human and caused deep punctures, bruising, or damage caused by holding onto the bite?
- Has not bitten
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
In the last 3 months, how many times has your second dog bitten a human and caused deep punctures, bruising, or damage caused by holding onto the bite?
- Has not bitten
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
In the last 3 months, how many times has your third dog bitten a human and caused deep punctures, bruising, or damage caused by holding onto the bite?
- Has not bitten
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
As far as you know, how many times in its life has your dog bitten and caused serious damage to a human- multiple bites in one incident, and/or grabbing and shaking- that required immediate medical attention?
- Has not bitten
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
As far as you know, how many times in its life has your first dog bitten and caused serious damage to a human- multiple bites in one incident, and/or grabbing and shaking- that required immediate medical attention?
- Has not bitten
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
As far as you know, how many times in its life has your second dog bitten and caused serious damage to a human- multiple bites in one incident, and/or grabbing and shaking- that required immediate medical attention?
- Has not bitten
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
As far as you know, how many times in its life has your third dog bitten and caused serious damage to a human- multiple bites in one incident, and/or grabbing and shaking- that required immediate medical attention?
- Has not bitten
- 1-3 times
- 4-6 times
- 7-10 times
- Very frequently (more than 10 times)
Has your dog ever injured another animal? Please specify.
Has your first dog ever injured another animal? Please specify.
Has your second dog ever injured another animal? Please specify.
Has your third dog ever injured another animal? Please specify.
Goals & Priorities
What do you consider to be the #1 PROBLEM that you’re struggling with?
What do you consider to be the #2 PROBLEM that you’re struggling with?
What do you consider to be the #3 PROBLEM that you’re struggling with?
What is your #1 GOAL with your dog?
What is your #1 GOAL with your dogs?
Thank you for taking the time to fill out our survey. Please understand that not every situation is the right fit for our programs or schedule. After hitting 'Let's Get Started,' be sure to read what comes next in your dog's training journey!
SMS Message Consent & Agreements*
By submitting this form, you agree to receive non-automated text messages from Chucktown Charley related to scheduling appointments, reminders, important updates, and general two-way communication about training, lodging, playcare, or spa services. Message & data rates may apply. Message frequency varies. Carriers are not liable for delayed or undelivered messages. Unsubscribe at anytime by replying STOP or CANCEL. Reply HELP for support. Privacy Policy and Terms & Conditions.
Recurring SMS Message Terms and Conditions. Effective Date: 2.19.2025.

By opting in to receive SMS messages from Chucktown Charley, LLP [also known as Chucktown Charley] (“we,” “us,” “our”), you agree to these Terms and Conditions (Terms).

SMS Messaging Service By providing my phone number, I consent to receive SMS text messages from Chucktown Charley for appointment reminders, scheduling, special offers, promotions, important updates, and general two-way communication about training, lodging, playcare, or spa services. Message and Data Rates may apply.

Message Frequency You will get more than one message from us unless you opt-out, and while messaging frequency varies, you will likely receive up to 4 messages per month. Chucktown Charley reserves the right to alter the frequency of messages at any time to increase or decrease the total number of messages. Chucktown Charley and carriers are not liable for delays or undelivered messages.

Message and Data Rates Message and data rates may apply based on your mobile carrier’s terms.

Privacy Policy Your information will be handled in accordance with our Privacy Policy: https://www.chucktowncharley.com/privacy.

Cancellation/Opt-Out Instructions You can opt out of receiving SMS messages at any time by replying STOP to any message we send you. After you opt out of text messaging, you will receive one additional message confirming your request has been processed.

Help/Customer Support Text the word HELP for support. You may also contact us directly at hello@chucktowncharley.com.

Liability We are not responsible for any charges, errors, or delays in SMS delivery or undelivered messages caused by your carrier or third-party service providers.

Useful Pages

843.559.0680

Welcome to the First Step in Transforming Your Dog’s Life

Why Choose Chucktown Charley?

Your Role in the Journey:

Goals & Priorities

Thank you for taking the time to fill out our survey. Please understand that not every situation is the right fit for our programs or schedule. After hitting 'Let's Get Started,' be sure to read what comes next in your dog's training journey!

Useful Pages

Our Dog Training Partner

Pick Up and Drop Off Hours