Name
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First Name
Last Name
Spouse/Significant Other Name (or write none)
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Email Address
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Cell Phone
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(###)
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Home Phone
(###)
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Spouse/Significant Other Cell Phone
(###)
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Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Residence Type
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House (own)
House (rent)
Condo
Apartment
Acreage
Other (please explain)
If you answered other, please explain:
Does your home have any of the following (please check all that apply)?
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Fenced yard
No Fenced yard
Dog Door
Swimming Pool (that your dog could go swimming in)
Dog run/kennel
Dog crate
Public park (near your home)
Dog Park (near your home)
Beach (near your home)
Field (near your home)
Wooded area (near your home)
Off-leash area (near your home)
Do you, or does anyone in your household, smoke cigarettes, cigars, pipes, e-cigarettes, ect? (This includes inside or outside the home)
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Yes
No
Occasionally
Do you use any of the following fragrances in your home? (please check all that apply)
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Glade Plugins
Scented Candles
Essential Oil
Fragrance sprays
Incense
Perfume/Cologne
Other
None
What product(s) do you clean your floors with?
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What product(s) do you use for lawn maintenance/weeds? Or write "no lawn."
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Occupation(s)
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Hours worked per day
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Hours worked per week
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Do you work from home?
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Yes Always
No Never
More than half of the time
Less than half of the time
Spouse/Significant Other Occupation(s)
Spouse/Significant Other hours worked per day
Spouse/Significant Other hours worked per week
Does Spouse/Significant Other Work from home?
Yes Always
No Never
More than half of the time
Less than half of the time
Would you, or your significant other be able to take your dog to work with you?
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Yes
No
Part of the time
One or both of us work from home
Marital/Family Status
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Single (no children)
Single (with children)
Married/Significant Other (no children)
Married/Significant Other (with children)
Your Age
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Spouse/Significant Other Age
Ages of Children (separate with commas, write none if no children live in your home.)
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Allergies
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Yes (please explain below)
No
Explain Allergies (if any)
Will this be your first dog?
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Yes
No
Do you currently have any dogs?
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Yes
No
If you currently have dogs, please list breeds, age, and sex. If not, write none.
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If you have had dogs in the past, please list the breed and why you no longer have them. If they passed away, please list the age and cause of death. If you have never had dogs, write none.
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Do you currently have other pets? (please check all that apply)
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None
Cat
Bunny
Bird
Chickens
Turtle
Snake
Rodent
Fish
Horse/Farm Animals
Other
Are your dogs spayed/neutered?
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Yes, all spayed/neutered
No, none spay/neuterd
Some are, and some are not
Have no dogs
Do you plan to spay or neuter your Eurasier?
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What are your current dogs feed? If kibble, what is the brand? Or write no current dogs.
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Please list what you will feed your Eurasier
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Have you, or would you, feed your dog(s) raw meats?
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Yes, I have before, and yes I will again
Yes, my current dogs are raw feed
No, I have never feed raw meats, and have no interest
No, I have never feed raw meats, but I would like to
How do you feel about feeding raw meat, bones, and organs to your Eurasier?
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How often was your previous or current dog vaccinated? Write NA if you've never had a dog before.
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How do you feel about vaccines?
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Do you know what a titer is?
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Yes
No
I have heard of it, but not sure what it is
Have you ever had a titer done before?
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Yes
No
Do you, or would you, use flea and tick medications?
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Yes
No
Do you, or would you use worm/heart worm medications?
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Yes
No
How do you feel about NR Breeding?
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Would you commit to purchasing the non-toxic bowls, toys, and bed that I recommend on my website? (I do not make any money from your purchase; speaking as a customer myself, they are amazing, durable, and safe products.)
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Why do you want a dog?
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For my spouse
For my children
For companionship
For aid
For security
Other (please explain)
If answered other, please explain
Do you prefer a male Eurasier pup, female Eurasier pup or either?
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Male
Female
Either male or female (no preference)
If you have a preference for a Male or Female pup, please explain why (or write no preference.)
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If there are no pups available for your preferred sex, are you willing to take the opposite sex? (or write no preference)
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Do you have a color preference (please explain)
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Are you interested in
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Conformation/Show
Obedience
Agility
Breeding
Companionship
Tracking
Service Dog
Therapy Dog
Would you be interested in owning a Eurasier stud?
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Yes
No
Maybe
Would you be interested in breeding a Eurasier female?
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Yes
No
Maybe
Have you ever bred any breed of dog before?
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Yes
No
Please describe the characteristics you would like in an ideal dog. Please be very detailed as this is very important to be sure you get the best fit for you and your family.
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What kind of interests (hobbies) and activities do you and those in your household participate in?
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Please describe how a Eurasier will fit into your family
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Is anyone in your immediate or extended family fearful of dogs?
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Yes (please exaplin below)
No
If answered yes, please explain
How did you hear about the Eurasier breed? Please explain
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Why are you interested in a Eurasier? Please explain
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What kind of exercise will you do with your dog?
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Daily walk
Training
Play brain games
Jogging
Running
Hiking
Swimming (if they like water)
Other (please explain)
None
If answered other, please explain
Please describe the weekday routine of your Eurasier
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Please describe the weekend routine of your Eurasier
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Where will your Eurasier live?
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Inside
Outside
Freely moving between both via a dog door
Explain further (where your Eurasier will live) sleeping arrangments, when you are not home, etc
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How many hours of the day will the Eurasier be left without direct human physical contact?
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When left alone or without direct human physical contact, where will the Eurasier be kept?
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Who will be the primary caregiver (feeding, grooming etc)?
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Outside of family members, who else might care for your Eurasier (e.g. neighbors, dog sitters, pet boarding etc.)?
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When vacationing, what arrangements will be in place for care of your Eurasier?
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Would you use boarding kennels?
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Yes
No
Maybe
Do you know the costs of local boarding kennels? (NOTE: We do care for local Eurasiers when owners are away at $30 a day.)
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Yes
No
Are you personally acquainted with those who have boarding kennels in your area?
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Yes
No
Are you aware of the grooming requirements for a Eurasier?
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Yes
No
Would you use a professional groomer?
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Yes, on a regular basis
No, I would do all the grooming myself
Both, I would use a groomer, and do it myself
Have you ever been to a holistic vet?
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Yes
No
How do you feel about training and obedience? Would you ever drop off your puppy at an extended stay training program?
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Have you ever trained a puppy before? If so, what breed?
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Will you be doing all the training yourself? If not, will you be working together with a trainer and your pup? Are you aware that Eurasiers need gentle, not harsh training methods? Please never put a prong, choke, or shock collar on your Eurasier, as they are a very sensitive breed.
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As I stated on my website, I will be working with a program called Puppy Culture, so your puppy will be very familiar with a clicker by the time they come home. The program is from 0 to 12 weeks. Would you be interested in learning the 8-12 week portion of the course?
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How much would you say you know about the Eurasier breed?
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A lot
A good amount
Some
Very little
Are you interested in a lifelong relationship with your breeder?
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Yes
No
Not Sure
It is recommended that exams for hips, elbows, patella luxation, thyroid, and eyes be given when the Eurasier reaches 2 years of age. Costs vary between $500-$1200 depending on location. Do you plan to proceed with this testing whether you breed or not?
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Yes
No
Maybe
Would you commit to sending photos and quick updates at least monthly until the pup is one year old, and then every 6-12 months after that for life?
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Yes
No
Not Sure
Will you (or your significant other) be posting photos of your puppy on social media as they grow?
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Yes, Facebook
Yes, Instagram
Yes, Other
No
One condition of sale is the mandatory enrollment in, weekly participation in, and graduation from a reputable PUPPY socialization class. It is extremely important for your puppy to interact with other PUPPIES and not just adult dogs. Classes are usually once a week from 8 weeks to 16 weeks. Please note: good classes are hard to find, so you would need to start researching now. Is finding and attending a good class weekly something you would commit to?
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Yes
No
Not Sure
How do you feel about the mandatory puppy socialization class requirement?
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If for any reason your family can no longer keep your Eurasier, one condition of sale is that you must first contact the breeder to discuss options about finding a new home for your Eurasier. We must be given the option of taking the Eurasier back. We are happy to work with you if you have a home. We do not want the Eurasier to be placed in a shelter - EVER!! Do you agree to this condition of sale?
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Yes
No
Not Sure
Relocation
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New baby in family
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Newly acquired allergy to the dog
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Severe financial problems
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Divorce/Separation
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Death of owner(s)
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I do not ship my puppies, are you willing and able to pick up your Eurasier puppy in person?
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How did you hear about me, or find my website?
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Any questions, comments, or concerns you may have: