Potential Client Questionnaire - Alta-Tollhaus German Shepherds

Thank you for taking your time to complete this questionnaire. The main 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:

Name:

Occupation:

Employer:

Spouse/Partner’s Name:

Spouse/Partner’s Occupation:

Spouse/Partner’s Employer:

Street adress

City

State

Zip/Postal code

Country

Your e-mail *

Spouse/Partner’s Email:

Phone

Cell

Other

1. How many adults live in your home other than yourself and your spouse/partner?

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

Yes
No

If Yes, so please provide more detail:

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. As an adult, have you owned dogs previously?

Yes
No

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

9. Do you have other animals?

Yes
No

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

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

Yes
No

If Yes, please provide details:

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

Yes
No

If Yes, please provide details:

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

Yes
No

If Yes, please provide details:

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

Yes
No

If Yes, please explain the circumstances:

14. Have you ever euthanized a pet?

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.)

Other, please describe:

16. Physical Attributes

Check your Preferences in a GSD—if not important to you, please check that box.

Gender:

Male
Female
Either
Not Important

Age:

Puppy
Adult
Either
Not Important

Color Pattern:

Saddle
Sable
Bi-Color
Not Important

Coat Type:

Stock Hair (Normal)
Long Stock Hair
Not Important
Not Important

Size:

Standard
Larger
Smaller
Not Important

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

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

Would be nice, but you can take or leave:

17. Temperament, Personality, Energy, Intelligence

Check your Preferences in a GSD (Check all that apply.)

Other, list or explain:

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

Other, list or explain:

19. Do you own your home?

Yes, I have my own house
No, I rent my house

20. Please describe your home and property:

21. Where will your dog live – inside, outside, combination?

22. Please describe the living conditions you will provide for your dog:

23. Do you have a fully enclosed fenced yard or outdoor secure confinement?

Yes
No

If Yes, please describe, height, dimensions, type, etc

If No, what is your plan to manage outdoor time for your dog?

24. Is there or have there been any issues with neighbors involving dogs – yours, theirs, or others?

25. Please provide the name and phone number of the DVM you currently use or have used in the past:

Veterinarian’s Name

Phone Number:

Veterinarian’s Phone Number

26. How do you plan to train your dog?

27. If you plan to attend a training school what is the name, website, and phone number?

Name of School:

Phone number

Website:

28. Have you worked with a trainer in the past that will furnish a reference for you?

Yes
No

If Yes, what is their name and contact information:

29. Have you previously titled dogs?

Yes
No

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

What breed of dog?

What venue?

30. Please provide two other references – include: name, relationship, and phone number:

First reference

Please provide two other references – include: name, relationship, and phone number: (copy)

Second reference

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?

Do you have any questions for us?