The purpose of this questionnaire is to help
us get to know you better and help you in your quest to obtain the right family
Fill out the information in each section
as requested. Then when you are finished, click on the Submit button to send the
form to us.
Postal Code/Zip Code:
Residential Phone #:
Cellular/Work Phone #:
Marital status (include common-law
Number of people living in home:
Ages of children living in home (even if
Type of dwelling
Type of community (rural, city, small town):
How long have you lived at this address?
Do you have a securely fenced yard - size
appropriate for an active dog?
Do you rent or own your home?
If you are currently renting, do you have
plans to purchase a home in the near future?
Does your landlord know of and approve of
you getting a dog?
Does anyone in the home have pet allergies?
Does anyone have a fear of dogs?
What do you like to do during your leisure
Where do you normally vacation and would you
take your dog with you?
Would your extended family/friends object to
you bringing your dog to stay at their homes when you visited?
Do you have dog ownership experience? (as an
What became of the dog(s), if you no longer
Do you currently own a dog?
Do you currently have any other pets?
Species/breed & ages of pets:
Have you ever had to re-home a pet?
If yes, what were the circumstances that
lead to re-homing:
Have you ever had a dog with behavioral problems?
If yes, how did you resolve the problem?
Is proper veterinary care and a good quality
diet important for your dog?
Where do you think you would be most likely to buy your pet food?
RAW Dog Food Distributor
Make My Own
Are you familiar with the RAW or B.A.R.F. diet?
Are you aware of the benefits of feeding a raw diet?
Do you currently feed a raw diet to your pets?
no but I am interested in switching
Is this a diet you would be interested in feeding?
Are you willing to follow the feeding protocol recommended by the breeder?
Are you aware of the changing vaccine protocols now recommended by
national veterinary associations?
Are you concerned about the safety of vaccines?
How often should pets be vaccinated?
every 3 years
whenever my vet recommends it
only in puppyhood
Are you willing to follow your breeder's vaccine protocol recommendations?
Do you plan to have your dog spayed/neutered?
Do you have a preference for the sex of your dog?
Are you planning to add any other pets to your home in the near future?
If yes, when and what type of pet?
Why A Toller?
What interests do you hope to pursue with this dog?
Family Pet Only
Do you have experience with the activities that you have
What made you choose this particular breed?
What is your least favourite thing about
Have you had a chance to meet/get to know a Toller?
If yes, whose dog was it?
What kind of energy level are you looking for?
Will your dog live at the above address?
Would you agree to us visiting your home
before placing a dog with you?
Where will your dog spend most of its time?
In the house
Outdoor dog run
Tied up outside
Wherever I am
Where will your dog be when you are working or away from home?
Inside at home
Outside at home
Where will your dog sleep at night?
How do you plan to manage your dog's outdoor time?
How much exercise do you think a Toller requires on a daily basis?
Have you ever attended obedience classes?
Would you mind if the Breeder makes this a requirement of ownership?
How many hours will the dog normally spend at home alone each day?
How many days per week would the dog be home alone?
Who will be the main person responsible for this dog?
Which is more important to you in choosing a
Has puppies available right away
Has an adult dog available
No rules or strings attached to ownership
Trains/competes in the events that interest me
Is ethical and reputable
Is a RAW feeder/limited vaccines
Close to where I live
Will choose the right puppy for me
When are you hoping to be able to bring a
dog into your home?
How did you hear about our kennel?
Other Toller Breeder
Torlan Toller owner
NSDTR Club of Canada
Are you currently on the waiting list of any other Toller breeders?
Thank you for taking the time to answer the
questions in our questionnaire.
By providing us with this information, we hope to better understand why you
want to add a Nova Scotia Duck Tolling Retriever to your home and whether we
have the type of dog that you are looking for.
All information is treated with the utmost confidentiality and will not be
passed to anyone without your permission.
Copyright © 2005 [Torlan Tollers Reg'd]. All rights reserved. Revised: December 2012
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