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Address
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United States
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How did you hear about us
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Referral
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Previous meeting
You've owned one of our dogs before
If Referred: By whom?
Do you own your own home?
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No
If renting: Does your landlord let you own dogs up to 80 lbs?
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Yes
No
Do you have a fenced in yard?
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Yes
No
How far is your house from the street?
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List pets you currently own, how old they are and how long have you owned them
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List the dogs you have owned in the last 10 years. and type of breed they were.
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What has happened to the previous dogs you have owned?
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Your Vet's Name, address and phone number so we can call for reference.
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If you have a groomer, Name, address and phone number
List members of your household including ages.
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Is anyone home during the day?
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Yes
No
If no one is home during the day, list provisions you will provide for the puppy.
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Does anyone in your house have allegories to dogs or cats?
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Yes
No
Are your current pets on heart worm preventive?
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Yes
No
Are you familiar with local animal ordinances?
Yes
No
Do you plan to tie or chain your collie outside at anytime?
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Yes
No
Are you or your spouse in the Military?
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Yes
No
May I come or send someone for a home visit?
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Yes
No
Has your pet ever been taken to Animal Control or Pet Rescue?
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Yes
No
If yes, please explain:
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Have you ever had a pet stolen or lost?
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Yes
No
Have you ever had a pet that was poisoned?
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Yes
No
Have you ever had a pet hit by a car?
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Yes
No
Have you ever had a pet die of a disease?
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Yes
No
Have you ever had a pet you had to get rid of?
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Yes
No
Please explain if you answered yes to any of the above questions:
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What are your plans for training and socializing your puppy?
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Do you prefer Adult or Puppy?
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Adult
Puppy
Do you prefer Male or Female?
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Male
Female
Would you consider either sex?
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Yes
No
Do you prefer rough or smooth coat?
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Rough
Smooth
What color do you prefer?
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Please Select
Sable
Tri
Blue Merle
White
Doesn't Matter
Are you currently on a waiting list from another breeder?
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Yes
No
Will you be crate training your puppy?
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Yes
No
Are you familiar with your local Collie Club?
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Yes
No
Are you familiar with the Collie Club of America?
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Yes
No
Are you familiar with The Collie Health Foundation?
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Yes
No
Are you familiar with the MDR1 gene?
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Yes
No
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