How did you find us? (Referral from another buyer, Breeder Directory, etc.)

Age 18-40 41-60 60+
Other adults in your home:

Do you have any children? Yes No
If so, what are their ages, and have they been exposed to dogs in the past?

Were there ever any problems with your children & dogs?

Do all family members agree on the addition of an Aussie to the family? Yes No
If not, who is not in favor of getting an Aussie and why?

Who will care for this dog if you should become incapacitated, temporarily or permanently?

Do you agree that, if for some reason you are unable to care for this dog, we will be contacted about its relocation and will have first right of refusal? Yes No
Do you Own or Rent your home?
If your home is a rental will your landlord be willing to sign a statement allowing you to keep an Aussie? Yes No
How many hours will this dog be left alone per day?

Where will the dog be when no one is at home?

Does your family have enough "quality" time to devote to a dog? Yes No
Are you willing to take responsibility for this dog for the next 10 or more years? Yes No
How long did your last pet live and what were the circumstances of its death?

Have you ever returned a pet to the breeder? Yes No
If so, what were the circumstances?

Have you ever given a pet away? Yes No
If so, what were the circumstances?

Have you ever given up a dog to a shelter or pound? Yes No
If so, what were the circumstances?

How many dogs do you have now?

What breeds?

Have you owned Australian Shepherds before? Yes No
How recently?

What are your reasons for choosing one now?

Are you aware of the socialization needs of an Aussie puppy and do you feel you are capable of providing for these needs? Yes No
Do you have pets other than dogs? Yes No
What are they?

Is your yard fenced or do you have a fenced enclosure for the dog? Yes No
If you answered "No" to the last question, how to you intend to exercise this puppy?

How large and of what type is the enclosure?

Do you let your dogs run loose (at large)? Yes No
Do you intend to house your dog: Inside Outside Both
Have you ever used a crate to confine your dog? Yes No
Are you willing to have the puppy OFA'd (hips/elbows x-rayed, approx. cost $200-$300) at the age of 24 months, and have the puppy's eyes checked on a yearly basis?  Please CAREFULLY consider this question and your response before answering.   Yes No
What area(s) of interest would you like to pursue with your Aussie? Working stock, conformation, obedience, agility, pet/companion, 4-H project, trick dog (please list all applicable)

Other (please explain):

If you plan to work your Aussie, what type(s) of livestock will be used?
What sort of working drive do you feel would mesh with your personality, i.e. hard, sharp, moderate, low…and why?
Have you ever trained a dog for livestock before? Yes No
Have you ever worked or handled a dog on livestock before? Yes No
Have you ever shown in: conformation? Yes No
Obedience? Yes No
If yes, where and to what extent?

Are you willing to enroll this dog in at least one structured obedience class? Yes No
Do you have a strong preference for a particular color?  YesNo 
If yes, please indicate your preference(s) Red tri/bi Black tri/bi Red merle Blue merle No Preference
Do you prefer your dog to be: Male Female Male, Would Consider Female Female, Would Consider Male No Preference
Would you consider an older dog? Yes No
Would you consider a rescue, or abandoned dog? Yes No
If so, what is the maximum age you would accept?

Are you willing to travel to Alberta to meet the dam of the puppies? Yes No
If travel is impossible (and we do understand that it is in some cases) would you be willing to allow a home visit from one of our friends in your area? Yes No
Please give us two references of people that know or have known you and your pets.
Please give us the number of the local agency in your area that handles dog complaints.
Registration applications for all Australian Shepherds placed as pets will be held by us until we have been provided proof of spaying or neutering. Do you have any reservations about this policy? Yes No
If yes, please tell us about your reservations
 
Are you aware of some of the health problem which can appear in some Aussies today such as medication sensitivities? Yes No
Please provide any further knowledge you have regarding health problems that might appear in this breed.  What type of screening are you aware of, what type of screening is important to you?

Are you aware that Australian Shepherds are medium-sized and very active dogs that shed (sometimes quite profusely)? Yes No
Are you willing to deal with these attributes that are so much a part of an Aussie? Yes No
Please provide the name, address and telephone number of your veterinarian (or one who has worked with you in the past) as a reference:

Have you been in contact with any other Aussie breeders concerning purchase of a puppy and if so would you tell us who they are?

Are you currently on the waiting list for any other litters? Yes No

Further comments: Please feel free to add anything that you think would help us in choosing the  right puppy for you and, more particularly, why we should place a puppy with you.

Thank you for taking the time to complete this questionnaire.