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 dog. 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.
Personal Information
Name:
Mailing Address:
City/Town:
Province/State:
Country:
Postal Code/Zip Code:
Residential Phone #:
Cellular/Work Phone #:
Email Address:
Marital status (include common-law relationship):
Age(s):
Occupation/Spouse's Occupation:
Number of people living in home: 1 2 3 4 5 6 6+
Ages of children living in home (even if part-time):
Type of dwelling (apartment/condo/duplex/house):
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 time?
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?
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Dog Experience
Do you have dog ownership experience? (as an adult):
What became of the dog(s), if you no longer own them?
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? Choose one yes no
If yes, what were the circumstances that lead to re-homing:
Have you ever had a dog with behavioral problems? Choose one yes no
If yes, how did you resolve the problem?
Is proper veterinary care and a good quality diet important for your dog? Choose one yes no
Where do you think you would be most likely to buy your pet food? Grocery Store Pet Store Veterinarian RAW Dog Food Distributor Make My Own
Are you familiar with the RAW or B.A.R.F. diet? Choose one yes no
Are you aware of the benefits of feeding a raw diet? Choose one yes no
Do you currently feed a raw diet to your pets? Choose one yes no no but I am interested in switching
Is this a diet you would be interested in feeding? Choose one yes no
Are you willing to follow the feeding protocol recommended by the breeder? Choose one yes no
Are you aware of the changing vaccine protocols now recommended by national veterinary associations? Choose one yes no
Are you concerned about the safety of vaccines? Choose one yes no
How often should pets be vaccinated? Choose one annually every 3 years whenever my vet recommends it only in puppyhood never no idea
Are you willing to follow your breeder's vaccine protocol recommendations? Choose one yes no
Do you plan to have your dog spayed/neutered? Choose one yes no no preference
Do you have a preference for the sex of your dog? Choose one no preference male female
Are you planning to add any other pets to your home in the near future? Choose one yes no
If yes, when and what type of pet?
Why A Toller?
What interests do you hope to pursue with this dog? Family Pet Only Hunting Companion Breeding Stock Competitive Obedience Competitive Agility/Rally-O Show Dog Tracking Field Trials Other
Do you have experience with the activities that you have noted? Specify
What made you choose this particular breed?
What is your least favourite thing about this breed?
Have you had a chance to meet/get to know a Toller? Choose one yes no
If yes, whose dog was it?
What kind of energy level are you looking for? Choose one high moderate low
Will your dog live at the above address? Choose one yes no
Would you agree to us visiting your home before placing a dog with you? Choose one yes no
Where will your dog spend most of its time? Choose one In the house Fenced backyard Outdoor dog run Tied up outside Wherever I am
Where will your dog be when you are working or away from home? Choose one Inside at home Outside at home With me Doggie Daycare With friends/family Other
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? Choose one yes no
Would you mind if the Breeder makes this a requirement of ownership? Choose one yes no
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 breeder? Choose one 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 Lowest price
When are you hoping to be able to bring a dog into your home?
How did you hear about our kennel? Choose one Internet Other Toller Breeder Torlan Toller owner NSDTR Club of Canada Other
Are you currently on the waiting list of any other Toller breeders? Choose one yes no
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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