Rescue Questionnaire

Please fill out the below questionnaire if you are interested in a rescue puppy/dog. Please remember that we adopt to approved homes only.

You must fill out all fields to be considered.

~About You~

Your name:

Your address:

Your City, Prov., Postal Code:

Email address:

Your Phone number:

Are you over 18 years of age?
Yes
No

If not, does your parent or guardian support your acquisition of an Aussie?
Yes
No

Do you own or rent your home?
Own
Rent

If renting, do you have your landlord’s permission to keep a dog?
Yes
No

Do you have a fenced yard?
Yes
No

Fence Height and Type

Does fencing completely enclose a yard for the dog?

Do you have a pool?
Yes
No

If so, is is separately fenced?
Yes
No

Have you owned an Australian Shepherd before?
Yes
No

What made you decide to purchase an Australian Shepherd?

If you are looking for a performance prospect, have you ever competed/titled dogs in any area before (obedience, conformation, agility, herding, etc)? If yes what titles?


What other breed of dog have you owned? (If you haven't owned a dog before, please state.)

Do you still own the dog(s) mentioned above? If not, what happened to the dog(s)?

Have you ever surrendered an animal to the pound, SPCA, Rescue org. or returned one to it's breeder? If so, please explain the circumstances.

Have you ever euthanized an animal? If so please explain the circumstances.

Will you be willing to keep in touch with the rescue throughout your dog's life?



Do you currently own any other animals (non-canine) If Yes, please list them below:

If you currently do not own any dogs, can you tell me about your past exposure to dogs and dog ownership?

Do you have children?
Yes
No

If Yes, please list their names and ages below and give me a brief idea of their exposure to dogs:

On average, what do you plan to spend per year on food, veterinary care, etc. for your Australian Shepherd?

How much do you expect to pay for an Australian Shepherd puppy?

Have you spoken with any other Australian Shepherd breeders/rescues? If Yes, please list them below:

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

If yes from where?



Please list at least two references (Veterinarian, Trainer, person active in dogs or close acquaintance preferred). Please include a phone number for each reference and e-mail address if possible:



~About the Dog~
Do you prefer a male or a female?
Male
Female
 
No preferance 
Why?

Do you have a colour preference?
Yes
No

If yes what colour?
Black tri
Blue Merle
Red Tri
Red Merle

Would you consider a dog of another color or sex if your preferences are not available?
Yes
No

All dogs going through our program MUST be Spayed or Neutered. Are you be willing to have your Australian Shepherd Spayed or Neutered?
Spayed or Neutered
. Are you be willing to have your Australian Shepherd Spayed or Neutered?" value="yes">Yes
Spayed or Neutered
. Are you be willing to have your Australian Shepherd Spayed or Neutered?" value="no">No

What characteristics are critical to you in your selection of your new dog? What characteristics are important but not absolute?

What type of personality are you looking for in your dog?

What is the time frame you would like to get your new Aussie in?


Do you plan to participate on any of the following activities with your Australian Shepherd?
(Check all that apply)
Obedience
Herding
Agility
Tracking
Flyball
Therapy
Breeding
Other:

How many hours on the average will the dog spend alone?

Where will this dog spend the day (Check all that applies)
Loose indoors
Crate
Basement
Garage
Fenced Yard
Kennel Run
Loose outdoors
Other:

Where will this dog spend the night (Check all that applies)
Loose indoors
Crate
Basement
Garage
Fenced Yard
Kennel Run
Loose outdoors
Other:

Are you aware of the excersise, grooming, and training requirements of this breed?
Yes
No

What are your plans for training and exercising your Australian Shepherd?

How will you housetrain your puppy/dog(if the dog is not already houstrained)?

How will you obedience train you puppy/dog?

Are you prepared to commit to a minimum of basic obedience training under the supervision of a professional?
Yes
No
Any additional comments?

Thank you very much, we will get in touch with you in a few days. If you have not heard from us in 5 days, please contact us to make sure we received it. Thank you.

*Please Note: Filling out our Rescue Questionnaire in no way guarantees you a dog from us. It is only the beginning of the interview process.  Dogs will not be placed into any home, when all communication has been done via email.  Please be prepared to come to our home, to meet ourselves, and our dogs, or, if you are a far distance from us, be prepared to have a home check done by a fellow breeder/rescue personnel in your area.