Companion/Performance Questionnaire

MUST BE FILLED OUT ON A COMPUTER - NOT A PHONE!

Companion Questionnaire:

* Indicates required field

Name - (Mr.) *

First

Last

Name - (Mrs.) *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number - Home *

Phone Number - Cell (Mr.) *

Phone Number - Cell (Mrs) *

Email *

Additional Email for spouse *

Do you own your home? Is it a single family, townhouse or Condo or Apt.? If you rent do you have the Landlords permission to have a dog? *

How much land do you have and is your yard fenced? If fenced how high and what type of fencing is it? Are there gates that can be opened? *

Do you have a pool? If so is it fenced separately? or would dog have access to it all the time? *

What are your occupations? *

What are the work schedules for the adults who live in your home? Again please be specific. *

Does anyone in your home smoke, if so do they smoke inside the home? *

Have you ever had a dog that you had to place or euthanize due to bahavorial issues? Please give details. Please list any current or past dogs *

Do you have dogs now?Please list a history of current or past dogs. *

Does anyone in your household have allergies? How many adults and how many children live in your home? If you have children how will they be supervised around the puppy? *

Have you owned either an Aussie or English Cocker in the past? Which breed are you interested in and what has drawn you to this breed? *

If you do not have a fenced yard how will you handle exercising your dog and potty needs? Please be specific! *

What method do you use to housebreak a puppy? Be specific *

How do you plan on providing adequate exercise for your puppy? And please be specific what do you intend to do to "Socialize" your puppy? Be specific *

Do you have any plans to move in the next 10-15 years? If so what would happen to the dog? *

Where will the puppy spend it's day, be specific please; crate, ex-pen, loose in the, basement,outside, etc. *

Where will the puppy spend the nights, in what room in your home and will it be in a crate or loose in the room? again please be specific. *

How many hours each day will the puppy be alone? *

Who will be the primary caregiver? *

Have you ever taken a formal obedience class? Will you be willing to take one with this puppy? *

Do you travel often and if so where will the puppy be at those times? Also if you travel with your dog, how does the dog ride in your vehicle? *

All companion puppies are sold on a spay/neuter contract with the spay/neuter to occur at the age of 2 years of age, does this present a problem for you? And do you agree that you will provide proof to Breeder of such spay/neuter? *

Are you aware of problems with over vaccinating and are you on board with limiting them and doing titres rather than just giving the dog a vaccine? How would you handle if your Vet recommends something that contradicts what I have told you? *

What would you do if you had any training or behavorial issues with your puppy? *

In the event that you could no longer care for the dog, for ANY reason are you willing to contact the breeder and give breeder the change to take back the dog? *

Do you plan to groom the dog yourself? If you are going to have it professionally groomed - how often would you do that? *

Are you able to and prepared to trim your dogs nails yourself? And are you prepared to clipper their face and ears? *

Are you financially prepared for any pet related emergencies that could occur? *

Please tell me what you plan for your puppy? (companion, agility, obedience, tracking, herding, field work, other)? *

What is most important to you when looking for a puppy for your family? *

Do you have a preference of sex *

Male Female

Do you have a color preference? *

Yes No

What is your color preference? *

Please tell me if I am unable to accommodate your request for a particular color or sex, are you willing to take another sex or color? *

How did you find me? *

Is there anything else that you would like to tell me about you or your family? *

Please provide me with 3 references (names/addresses & phone #'s) Please start with your current or past Veterinarian. Also list if you belong to any dog related group(s). *

Submit

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