YOUR PREFERENCES
Do you have a time and/or patience to housetrain a dog, if it is not already trained?
Select One
Yes
No
Would you be willing to take a "Special Needs" (scared, shy, handicapped, or need medication) dog?
Select One
Yes
No
Possibly
Would you be willing to work with a "behavior problem" dog?
Select One
Yes
No
Possibly
Do you have a age preference?
Select One
No Preference
8 weeks to 4 months
4 months to 1 year
1 year to 3 years
3 years to 9 years
Senior (9 years and older)
Would you be willing to take an older dog?
Select One
Yes
No
Possibly
Up to what Age?
Do you have a color preference?
Select One
No Preference
Tri-Color
Sable
Blue Merle
Do you have a size preference?
Select One
No Preference
Standard Size (13" to 16")
Smaller than Standard
Larger than Standard
Do you have a sex preference?
Select One
No Preference
Male
Female
Will you take the opposite sex?
Select One
Yes
No
Do you have a personality preference, ie: Couch Potato, Frisbee Dog, Jogging Partner, Quiet Companion, Senior, etc.?
Please Explain:
Please put the following in order of importance to you:
I want my new Sheltie to:
Play with my other dog
Play with my children
Go walking or running with me
Be affectionate and cuddly
Be a good watch dog
Become a performance dog
Be very laid back and calm
Go for car rides
Be totally housetrained
Not be shy with strangers
Have lots of energy and exuberance
Other (Please
Explain)
SHELTIE HABITS
Have you ever owned a Sheltie before?
Select One
Yes
No
Are you aware of all a Shelties needs and habits? (i.e. regular grooming, exercise)
Select One
Yes
No
Are you aware that Shelties are "barkers"? (doorbell, phone, UPS man, mailman, strangers, etc.)
Select One
Yes
No
Are you aware that a Sheltie is a longhaired, double-coated breed, one that will shed ?
Select One
Yes
No
Are you aware that Shelties may be somewhat shy around new people, and may take a while for bonding to take place?
Select One
Yes
No
Are
you also aware that because of their reserved nature, Shelties are a
high runaway risk during the first month or more?
Select One
Yes
No
Your Current and/or Previous Pets
Tell us about your present and past
pets:
Do you currently
Select One
Yes
No
If YES, please describe below:
If any of your present or past pets are/were not spayed or neutered, please explain why:
Will you agree to keep all of your current pets, and your new Sheltie, up to date on all of the following:
Vaccinations?
Select One
Yes
No
Heartworm Prevention? What Brand?
Select One
Yes
No
Flea Prevention? What Brand?
Select One
Yes
No
Licensed in your County?
Select One
Yes
No
What dog food do you plan on feeding your new Sheltie?
Your Current Veterinarian Information:
Vet or Clinic's Name:
Phone Number:
Address:
City, State, Zip
My vet may be used as a reference:
Select One
Yes
No
If NO, please explain:
How often do/did your dogs get groomed?
Who is your groomer?
Groomer's
Phone Number:
Your Home:
Who lives in your home?
What are the ages? Important - List the age of every person living (even part-time) in your home:
What are the ages of frequent visitors, if they are minors, and how often?
What is the speed limit of the road you live on?
Type of home you live in:
Select One
House
Condo-Townhouse
Apartment
Duplex
Mobile Home
Other
If other, please explain:
How long have you lived there?
Do you own or rent?
Select One
Own
Rent
If renting, does your landlord allow pets?
Select One
Yes
No
Your Landlord's Name
Your Landlord's Phone Number
Do you have a yard for the dog to use?
Select One
Yes
No
Is your yard fenced, with no holes or gaps, on all sides, so that a small animal could not escape?
Select One
Yes
No
Not Yet, working on it
Describe the material and height of your fence?
**If you do not have a fence, please select one of the following:
I will walk it on a leash.
I plan on training this dog to stay in my yard.
I have a "tie-out" trolley or stake.
Other :
Please explain
How will you allow this dog to run and get exercise?
I will walk it on a leash for
miles every day.
I will take it to a large park or field nearby.
I have a large yard to dog can run in.
Other:
Please Explain
Does a door from your house open directly into the fenced yard?
Select One
Yes
No
How will your dog access the area
for relieving himself?
Do you have a swimming pool?
Select One
Yes
No
If YES, is it
Above Ground
Built-In
If YES, is it fenced in?
Select One
Yes
No
How tall is the fencing?
What kind of fencing is it?
Does your home have any steps and/or stairs?
Select One
Yes
No
If so, please describe:
Are you planning a move in the foreseeable future?
Select One
Yes
No
If you were to move, would you insist on a new house having a fenced yard?
Select One
Yes
No
IF you were to move, what would happen to this dog?
Select One
I would give the dog back to Sheltie Rescue
I would try and find the dog a home
I would take the dog with us no matter what
Depends on circumstances
Daily Schedule
Do all adults in the home work away from home?
Select One
Yes
No
Will any adults be home during the day with the dog?
Select One
Yes
No
Specifically, how many hours will this dog be home alone daily?
Where will this dog stay while home alone?
Select One
Loose in house
Crate in the house
X-Pen
Kitchen
Basement
Outside
Outdoor dog kennel
Other (explain)
If other, please explain:
Please check all that apply in your home:
Busy household - visits by friends, children, parties
Noisy - TV, stereo, machinery, tools, children playing
Moderate - normal comings and goings
Moderate - normal comings and goings
Quiet - "homebodies", few guests, stay home a lot
Lots of children in the neighborhood
Live on busy street or highway
Where will this dog spend most of its time?
Select One
Outside
Inside
Outside and in garage
Outside during the day and inside at night
Are dogs allowed in all rooms in your home?
Explain:
Where will the dog sleep at night?
Are dogs allowed on your furniture?
Select One
Yes
No
Financial Commitment
Are you aware of the financial responsibility of dog ownership, including vet care, medications, food, licensing, shots, grooming, etc.?
Yes
No
AKC reports it costs over $1,000 per year to properly care for a dog. Will this fit into your budget?
Yes
No
Not Sure
Will you agree to use only a premium, quality dog food for your Sheltie?
Yes
No
Long Term Commitment
If your Sheltie were to get loose and run away, would you be prepared to spend money for posters, ads in newspapers, and rewards, to find it? Would you go to these lengths?
Yes
No
Probably
Depends on Circumstances
Check any of the following circumstances that would cause you to give this dog back to us. (Check all that may apply)
A new job (working more, longer hours)
Kids getting busy, no time for dog
Divorce
Moving to a new house
New Baby
Dog needed expensive vet care
Bad habits (potty accidents, chewing, destruction, excessive barking)
Dog bit someone
Other ,
please explain:
Are you aware that the process of becoming approved may involve someone from rescue coming out to meet with you and do a home check?
Select One
Yes
No
How are you planning on getting this dog to you? (We don't ship dogs) Please explain:
