PUPPY QUESTIONNAIRE
The following questions are being asked of you so that the right puppy and the right placement of each puppy is
made by bringing the various requirements of both the puppy and his or new owner(s) into perspective, BEFORE a
choice is made. I hope you will agree that the animal's welfare must be my foremost consideration in considering a
placement. Please answer the following questions as completely as you can, and return this form when you've finished.
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• Name: Address: Phone (home): work:
• Referred by (if internet, which site?):
• Have you researched this breed at all? If so, what materials did you read/look at?
• Are you personally familiar with any Australian Shepherds?
• Type of dwelling: house condo apartment mobile home
• If renting, please give name and address of landlord:
• Name, address and phone number of your veterinarian:
• Are you over 18 years old and therefore able to enter into a contract? Y/N
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1. Who will be the primary care giver?
2. Where will the puppy be kept during the night?
3. Where will the puppy be kept during the day?
4. Is anyone home during the day?
5. How many hours on the average will the puppy be left alone?
6. Will there be someone available to feed and exercise the puppy during the day?
7. Have you ever owned a dog before?
8. Do you have any other animals? Type and age?
9. Do you have any children? If yes, what are their ages?
10. Does anyone in your household have allergies to animals?
11. If yes, to what and how severe?
12. Are you interested in a male or female puppy?
13. At what age do you wish to get the puppy?
14. How did you hear about this breed?
15. What do you expect the activity level of this breed to be: very high high moderate below average
16. What kind of floor surfaces will the dog be on in the house?
17. How many hours a day will the puppy be kept outside?
18. How will he be confined when he is outside?
19. Do you have a fenced yard? What size is your yard?
20. Have you ever house trained a dog before?
21. How long have you lived at this address?
22. Will you be attending any training classes?
23. How long did your last pet live? What were the circumstances of its' death?
24. Have you ever returned a pet to the breeder? If so, what were the circumstances?
25. Have you ever given a pet away? If so, what were the circumstances?
26. Have you ever taken a pet to a pound or shelter? If so, what were the circumstances?
27. Are you interested in showing the dog in the conformation ring?
28. Are you interested in competition in performance events such as obedience, agility, hunting, herding, etc.?
29. Do you intend to breed the dog?
Thank you for filling this out so we can match you with the right puppy!
Dana