Name: :
Street Address: :
City: :
State: :
Zip Code: :
Home Phone: :
Alternate Phone: :
Email Address: :
Do you own your home? :
yes no
If you rent your current dwelling, please provide contact information for you landlord: :
Will your dog have access to a securely fenced yard? Invisible Fences will not be considered. :
yes no
If not, do you plan to fence your yard before your puppy arrives? :
yes no
Do you have children? :
yes no
If so, please list their names and ages: :
If not, do you foresee children in the next several years? :
yes no
Does anyone in your family have pet allergies? :
yes no
Do you have other pets? :
yes no
Please list species and ages of current pets: :
Please list the name and number of your current veterinarian: :
Who will be your puppy's primary care giver? :
Is anyone home during the day? :
yes no
How many hours on average will the puppy be alone during the day? :
Where will the puppy be kept during the day? :
Where will the puppy sleep at night? :
Do you plan on crate training your puppy as a means of housetraining? :
yes no
Who will provide regular potty breaks during the day? :
How many hours on average will the puppy be outside during the day? :
Why do you think a Collie is the right breed for your family? :
Do you prefer a male or female puppy? :
Female
Male
No preferrence
If you prefer a male or female, please explain: :
Do you prefer a Rough or Smooth Collie? :
Rough
Smooth
If you would prefer a Rough Collie, are you prepared for the grooming requirements of its coat? :
yes no
Are you prepared for the housekeeping challenges presented by a Collie's shedding? :
yes no
What do you expect your Collie's activity level to be? :
Couch Potato
High
Moderate
Very High
Have you ever returned a pet to the breeder? :
yes no
If so, please describe the circumstances: :
Have you ever given a pet away? :
yes no
If so, please describe the circumstances: :
Have you ever taken a pet to a shelter, humane organization, or rescue organization? :
yes no
If so, please describe the circumstances: :
Have you ever consulted a professional trainer or behaviorist for problem behaviors in your pets? :
yes no
If so, please describe the training or behavior issue which led to the consultation: :
How would you describe the training methodology with which you most agree: :
Positive-reinforcement based training
Traditional, correction based training
Are you willing to provide routine health care for your pet? Check all that apply: :
Bathing as necessary
Monthly flea and tick prevention
Monthly heartworm prevention
Nail trimming weekly or biweekly
Vaccines in accordance with your veterinarian's suggested protocols
Yearly titers
Do you understand that some Collies may have a serious reaction to Ivermectin? :
yes no
Are you interested in showing your Collie in Conformation? :
yes no
Are you interested in showing your Collie in performance events such as obedience or agility? :
yes no
Are you interested in this dog for breeding purposes? :
yes no
Please type the text below :
