Potential Client Questionnaire - Alta-Tollhaus German Shepherds

Thank you for taking your time to complete this questionnaire. The purpose of this form is to introduce yourself to us. It allows us to begin to know you. It begins the process of assessing whether you and one of our dogs would be a good match for each other. We ask that you please answer all questions honestly. After you return the form to us, we will contact you to let you know if we think we can provide you with the puppy/dog that you are looking for. If we cannot we will try to provide you with other resources that you can pursue. If some of these question do not apply to you then skip that question or respond with “n/a” in the space.

Lastname:

First Name:

Occupation:

Spouse/Partner’s Name:

Spouse/Partner’s Occupation:

Street adress

City

State

Zip/Postal code

Country

Your e-mail *

Spouse/Partner’s Email:

Phone Land Line

Cell/Mobile

1. How many adults live in your home?

2. If applicable, do you have anyone living in your home with special needs?

Yes
No

If Yes, so please provide detail on how your future GSD will help engage with their needs:

3. Do you have children living with you or who spend a lot of time with you?

Yes
No

If Yes, what are their ages?

4. What are your hobbies/interests?

5. What are the hobbies/interests of the other family members?

6. Does every family member want a dog?

Yes
No

If No, please provide more detail:

7. Do you or anyone in your family have allergies to dogs?

Yes
No

8. If this is your first Dog or first GSD, why are you considering a GSD?

9. As an adult, have you owned dogs previously?

Yes
No

If Yes, please give details such as breed, gender, age, neutered/spayed/intact:

10. Do you have other animals?

Yes
No

If Yes, please provide detail – what kind, age, etc.:

11. Have you had unfavorable experiences with dogs in the past?

Yes
No

If Yes, please provide details:

12. Do you have any special concerns about dogs in general or about GSDs?

Yes
No

If Yes, please provide details:

13. Have you ever returned a pet to the breeder?

Yes
No

If Yes, please provide details:

14. Have you ever given a pet away, to an animal shelter, or a rescue group?

Yes
No

If Yes, please explain the circumstances:

15. What are your goals for your Alta-Tollhaus pup? For what purpose do you want a German Shepherd Dog? (Check all that apply)

If you selected Service or Therapy, please provide more details:

16. Gender

Male
Female
Either

17. Age

18. Color and Pigmentation:

Saddle – Black and Red
Saddle – Black and Tan

19. Size

Standard
Larger
Smaller
Not Important

20. Coat Type

Stock Coat
Long Stock Coat
Either – not important

21. Physical characteristics you absolutely want in your GSD? Please detail:

22. Physical characteristics you absolutely do not want in your GSD? Please detail:

23. Physical characteristics that would be nice to have but not an absolute:

24. Temperament, Personality, Energy, Intelligence

Check all that apply

Other, list or explain:

25. Check your Dis-likes in a GSD (Check all that apply.)

Other, list or explain:

26. Do you own your home?

I have my own house
I rent and my lease allows me to have a GSD
I rent but do not know if I am allowed to have a dog

Please describe your home and property.

27. Where will your dog live

My dog will be a housedog
My dog will live outside
My dog will live in the house and outside

28. When your dog is outside: check all that apply

Will be on leash with me or another person
Will be in a completely enclosed fenced yard
Will be in an area with invisible fencing
Will be able to roam my property freely
Will be on a tie-out
Will be on an overhead line
Will be in a dog run – kennel

29. How do you plan to train your dog? Check all that apply.

30. Have you previously titled dogs in any venue?

Yes
No

If Yes, please tell me about the titles you have earned with your dogs:

What breed(s) of dog have you titled?

What venue(s)?

31. What is your target date to bring home your new puppy?

32. Do you have any other comments in regard to your situation and the dog you are looking for?

33. Do you have any questions for us?