Puppy Questionnaire
This questionnaire is designed to give us some sort of an insight into why you have chosen an Australian Shepherd puppy for your
home, the life style you live, and what you plan on doing with your puppy. Australian Shepherds are a very active breed and demand
a lot of attention or he or she will develop entertainment or jobs on its own and sometimes that does not work in our busy lives. There
are so many Aussies who wind up in shelters, put down, or in rescue which if the breeder would have just taken the time to ask some
general questions their story may not wind up so sad. I know things happen that we can not control, but if you do get one of my pups,
and if you know longer can take care of the pup I ask that you please contact me and I’ll make every effort to either try and help you
find a new home or take my pup back as the breeder.
Directions for filling out the questionnaire:
Please print off (and send via snail mail) or copy and paste in email the questionnaire. If you are approved then a non-refundable
deposit of $150.00 will be required along with the contract to hold a pup. We will make every effort to fulfill your desire in a puppy and
what you are looking for. We make no promise in any litter since we have no control over sex, color, or quantity of pups. If the litter
does not produce what you are looking for then you will be offered another pup if possible. The waiting list will be first come first
reserve basis and will be offered accordingly as they come in. The sooner one gets the puppy contract in with deposit the higher you
will be on the list.
Personal Information:
Name: _______________________
Address: _____________________________
City: _______________________________
State: ___________
Zip Code: ________________
Home Phone: ___________________
Cell Phone: _____________________
Work Phone: ___________________ Ext: _________
Email: ____________________
Web Site: ________________________
Occupation & Life Style:
1) Do you own or rent your home?
2) How long have you lived at this address?
3) How large is your yard (or) how many acres?
4) Do you have a fenced yard?
5) If so, what type of fencing?
6) If you don’t have fencing, how will you handle the puppy’s exercise and toilet duties?
7) How many adults and children in the household?
8) Ages of you’re children or grandchildren if any or any other children within the home where the puppy will be living?
9) Do you own other dogs?
10) If yes, describe breed, sex, and age:
11) If you own other dog(s) are they neutered or spayed?
12) If you own cats are they de-clawed?
13) If you own a dog(s) and/or Cat(s) please give the name, address, and phone number of your veterinarian:
14) What is your experience with any dog?
15) Have you owned an Australian Shepherd before?
16) Why did you choose this breed?
17) What is your color preference?
18) Do you want a male or female?
19) Do you want show or pet quality?
20) How many dogs have you owned in the past ten years that are not presently living with you, what happened to the dog(s) ?
21) Will the puppy reside in the house?
22) If you work, how will the puppy spend its days?
23) How will the puppy spend the night? Crated or uncrated?
24) How many hours on the average will the dog spend alone per day?
25) When traveling in vehicles how will the dog ride (meaning crate, harness etc.)?
26) List all plans for this dog: Pet, Guard, Herding, Obedience, Breeding, Confirmation, Breeding, Agility, or Other:
Please provide any additional comments you would like to make:
This questionnaire is designed to give us some sort of an insight into why you have chosen an Australian Shepherd puppy for your
home, the life style you live, and what you plan on doing with your puppy. Australian Shepherds are a very active breed and demand
a lot of attention or he or she will develop entertainment or jobs on its own and sometimes that does not work in our busy lives. There
are so many Aussies who wind up in shelters, put down, or in rescue which if the breeder would have just taken the time to ask some
general questions their story may not wind up so sad. I know things happen that we can not control, but if you do get one of my pups,
and if you know longer can take care of the pup I ask that you please contact me and I’ll make every effort to either try and help you
find a new home or take my pup back as the breeder.
Directions for filling out the questionnaire:
Please print off (and send via snail mail) or copy and paste in email the questionnaire. If you are approved then a non-refundable
deposit of $150.00 will be required along with the contract to hold a pup. We will make every effort to fulfill your desire in a puppy and
what you are looking for. We make no promise in any litter since we have no control over sex, color, or quantity of pups. If the litter
does not produce what you are looking for then you will be offered another pup if possible. The waiting list will be first come first
reserve basis and will be offered accordingly as they come in. The sooner one gets the puppy contract in with deposit the higher you
will be on the list.
Personal Information:
Name: _______________________
Address: _____________________________
City: _______________________________
State: ___________
Zip Code: ________________
Home Phone: ___________________
Cell Phone: _____________________
Work Phone: ___________________ Ext: _________
Email: ____________________
Web Site: ________________________
Occupation & Life Style:
1) Do you own or rent your home?
2) How long have you lived at this address?
3) How large is your yard (or) how many acres?
4) Do you have a fenced yard?
5) If so, what type of fencing?
6) If you don’t have fencing, how will you handle the puppy’s exercise and toilet duties?
7) How many adults and children in the household?
8) Ages of you’re children or grandchildren if any or any other children within the home where the puppy will be living?
9) Do you own other dogs?
10) If yes, describe breed, sex, and age:
11) If you own other dog(s) are they neutered or spayed?
12) If you own cats are they de-clawed?
13) If you own a dog(s) and/or Cat(s) please give the name, address, and phone number of your veterinarian:
14) What is your experience with any dog?
15) Have you owned an Australian Shepherd before?
16) Why did you choose this breed?
17) What is your color preference?
18) Do you want a male or female?
19) Do you want show or pet quality?
20) How many dogs have you owned in the past ten years that are not presently living with you, what happened to the dog(s) ?
21) Will the puppy reside in the house?
22) If you work, how will the puppy spend its days?
23) How will the puppy spend the night? Crated or uncrated?
24) How many hours on the average will the dog spend alone per day?
25) When traveling in vehicles how will the dog ride (meaning crate, harness etc.)?
26) List all plans for this dog: Pet, Guard, Herding, Obedience, Breeding, Confirmation, Breeding, Agility, or Other:
Please provide any additional comments you would like to make:
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Puppy Questionnaire
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