Genesis Belgian Shepherds
  • Home
  • Belgian Shepherd Dogs
  • Belgian Health Information
  • Belgian Temperament and Training
  • Things to do with your Belgian
  • What is a Title and What do all those letters mean?
  • Recommended Reading
  • Belgians in Need
  • About Dog Breeders
  • Prospective Puppy Buyer Information
    • "Puppy Buyer Etiquette"
    • Sample Contracts
  • Litters/Puppies
    • Novel Litter (2011) >
      • Novel litter pedigree
    • Adventure Litter (2008) >
      • Adventure Litter puppies >
        • Dragon
        • Feather
      • Adventure litter pedigree
    • Justice Litter (2006) >
      • Justice Litter puppies
      • Justice pedigree
    • Chienbrun "E" Litter (2005)
  • Dogs at Genesis
    • Aslan
    • In Memory >
      • Quest
      • Justice
      • Spirit
      • Phantom
      • Mystery
      • Lainie
      • Trinity
      • Sharcole
      • Dickens
      • Magic
  • Contact Genesis
IMPORTANT UPDATE FOR PROSPECTIVE PUPPY BUYERS:  Due to recent regulations implemented by USDA/APHIS, hobby breeders with 4 or more intact bitches will lose their hobby-breeder status and be forced to become a commercially licensed kennel if they sell any puppies "sight unseen".  Even though I have only 1 female I intend to breed, I have others who are unspayed.  Because I want to raise my puppies in my home and not in some concrete kennel away from human & canine contact, this means that I am unable to ship any puppies to their new homes.  All new owners will need to come to Ohio to pick up their puppy.  We can arrange a meeting location, and I can drive a few hours to meet you along your route, or can meet you at the airport should you decide to fly.  Please contact me for more information.

Questionnaire for Prospective Puppy Buyers


Please review the Prospective Puppy Buyer Information page 
before completing this questionnaire. 

_______________________________________________________

There are two methods available to submit your questionnaire:

(Option 1) The first version below is a "fillable" form.  You can type your answers directly into the form, then click "Submit" to have your responses automatically sent.  After you have clicked "Submit," a popup ad will appear.  You can choose to view the ad by clicking "finish survey" or click "Continue" at the top of the popup to return to this page.

(Option 2) The second version below is text only.  To use this version, copy and paste the questionnaire into an e-mail message, then fill in your responses, and send to Genesis.  

Please note:  Though I try to respond within 48 hours or less, that is sometimes not possible--If you do not receive a response within a few days, I did not receive your message; please try again.

Prospective Puppy Buyer Questionnaire

Form Option 1 - Fillable HTML form.  You can type your answers directly into the form, then click "Submit" to have your responses automatically sent.  After you have clicked "Submit," a popup ad will appear.  You can choose to view the ad by clicking "finish survey" or click "Continue" at the top of the popup to return to this page.

As a breeder, my goal is to place each of my puppies in his or her “forever” home.  The process I use to evaluate potential homes begins with the questionnaire below.

Each puppy is an individual.  Just as no two children in a family are identical, no two puppies are exactly alike.  Nor are any two prospective homes the same.  During the first 8-9 weeks of the puppies’ lives, I will be observing and evaluating their physical and personality traits.  And I will compare my observations to the information on each questionnaire to try to determine the most appropriate home for each puppy by matching the needs of each individual dog to each prospective owner’s lifestyle.

Therefore, the answers you provide in this questionnaire are vital in assisting me to match your home with the right puppy.  There are no “right” or “wrong” answers.  Some of the questions may seem personal; however, candor and honesty are very important—remember, you're asking me to trust you for the lifetime of the dog.


PROSPECTIVE BUYER INFORMATION

Name:
Email Address:
Address:
City, State, ZIP
Phone:
(phone) home
work
cell
Alternate phone:
(alternate phone) home
work
cell

GENERAL INFORMATION

Why do you want a dog?
Are you acquiring a dog for yourself or for someone else?
If for someone else, are they aware of your intention, or is the dog to be a surprise?
Do you have children living with you or visiting regularly? If yes, please note gender and ages.
Are you prepared to teach any resident or visiting children the proper way to conduct themselves around dogs? yes
no
How do others in your household (spouse/significant other, parents, children, etc.) feel about the addition of a Belgian Tervuren?

Who in your family will be primarily responsible for:

- daily care of the dog
- clean up
- training
- exercise
- vet and food bills
How would you describe your household activity level? Very quiet
Rather easygoing
Usually something going on
Lots of activity
How did you learn about Belgian Shepherds?
Why do you want a Belgian Tervuren?
Have you considered other breeds? If yes, what breed(s) and why?
For each dog you currently own, please list the following: Name - Breed or mix - Sex - Age - Is pet spayed or neutered?
For each dog you have owned in the past 10 years, please list the following: Name - Breed or mix - Sex - Age - Was pet spayed or neutered? - Why do you no longer own the animal? (If deceased, please give age at death and cause of death.)
Do you have other pets? If yes, please list.
Do you regularly read any dog magazines? If yes, please list.
Have you read any dog health or training books? If yes, please list, and describe your general thoughts about these books.
Have you or anyone in your household ever been charged with animal cruelty? If yes, please explain.
Have you or anyone in your household ever had an animal taken away for suspicion of animal cruelty? If yes, please explain.
Have you or any person in your household ever had privileges suspended by the American Kennel Club, the United Kennel Club, the Canadian Kennel Club, or any other such club? If yes, please explain.

LIVING ARRANGEMENTS

Do you live in: apartment
house
mobile home
condo
In which type of area is your home located? urban
suburban
rural
Do you own or rent your home? own
rent
Do you have a fenced yard? yes
no
- If yes, size of yard, type and height of fencing.
- If no, please explain what arrangements you will provide for housebreaking and for safe & adequate exercise.
Are there any dog restrictions or laws in your area? Have you checked into local ordinances in your area pertaining to owning/housing an animal (e.g., leash laws, required vaccinations, dog licenses, etc.)? Are you willing to comply with any such laws?
Have you ever used a crate in housetraining a puppy or dog? Do you intend to use a crate for this dog?
If you have to be away from home for a few days and are unable to take the dog, what arrangements will you make to provide for his/her care?
What will you do with the dog when you go on a vacation or trip?
In the event of an emergency (e.g., hospitalization, natural disaster, etc.), who would take care of the dog?
If you were to move, what would happen to your pet(s)?
When you travel with the dog, where will he/she ride?
How do you envision a dog fitting into your home (schedule, indoor/outdoor activities, exercise, etc.)?
Where will the dog spend most of his/her time?
Where will the dog be when you are at home?
How long each day will the dog be alone?
Where will the dog be when you are away?
Where will the dog sleep?

YOUR INTERESTS/GOALS

Which of the following are you interested in? (Check all that apply.) puppy
older puppy
adult dog
Which gender of dog would you prefer? male
female
no preference
Please describe any physical attributes that are of particular importance to you in the puppy/dog you are seeking at this time.
Are you prepared to spay/neuter your dog, or are you interested in breeding? spay/neuter
breeding
undecided
What are your goals for your dog? Please check all that apply. Companion (pet)
Conformation/Showing
Agility
Herding
Obedience
Rally
Tracking
SAR
Therapy Dog
Assistance Dog
Messenger Dog
Flyball
Schutzhund
Other (specify below)
- If "other" checked above, please specify.
Please describe any character attributes that are of particular importance to you in the puppy/dog you are seeking at this time.
What do you expect of your Belgian?
What do you expect of your dog's breeder?

GROOMING, EXERCISE, AND TRAINING

Are you aware of the grooming requirements of the Belgian Tervuren? no
yes
Are you prepared to spend the required time grooming your Tervuren? no
yes
In addition to the normal routine at home, in what activities will your Tervuren participate? Check all that apply. Walk routinely with a family member
Go to classes
Compete in dog shows or performance events
Go to your place of business with you
Travel with you
Be a playmate for your children
Be a playmate/companion for other pets
Other (specify below)
- If "other" checked above, please specify.
Do you belong to any dog club or dog sports club? If yes, please list.
Have you ever trained a dog? no
yes
If yes, please describe how you trained and what commands were taught.
How do you intend to obedience train your Tervuren? (On your own? With a club/trainer? What commands will you teach and what training methods will you use?)
Are you aware of the SOCIALIZATION AND TRAINING requirements of the Tervuren? no
yes
Are you prepared to spend the required time SOCIALIZING AND TRAINING your Tervuren? no
yes
Have you ever experienced any behavior problems with past or present pets? If yes, how did you handle those problems?

OTHER

Are you prepared for the responsibility of caring for this dog for his/her entire life (10-16 years)? no
yes
How did you learn about Genesis Belgians?
May I or my representative visit your home? If no, why not?
Please add any additional information or thoughts that you feel would help me to understand you as a potential Belgian owner and the home you can offer to the dog.
What questions do you have for me?

VETERINARIAN INFORMATION AND OTHER REFERENCES

If you have a veterinarian, please provide contact information (Name, Mailing Address, Phone, E-mail).
Please supply contact information for two references (dog trainers, Belgian owners, friends, neighbors, etc.--not including immediate family) who know you well enough to recommend you as a good dog owner.
By signing/submitting this questionnaire, I affirm that all statements made above are true to the best of my knowledge. If you are submitting this form via e-mail, please type your name in the signature line below. I will require a signed copy before placing a puppy.) I agree
Signature (If you are submitting this form via e-mail, please type your name in the signature line. I will require a signed copy before placing a puppy.)

This form powered by Freedback
 


Prospective Puppy Buyer Questionnaire

Form Option 2 - This form is text only.  To use this version, copy and paste the questionnaire into an e-mail message, then fill in your responses, and send to Genesis.  

As a breeder, my goal is to place each of my puppies in his or her “forever” home.  The process I use to evaluate potential homes begins with the questionnaire below.

Each puppy is an individual.  Just as no two children in a family are identical, no two puppies are exactly alike.  Nor are any two prospective homes the same.  During the first 8-9 weeks of the puppies’ lives, I will be observing and evaluating their physical and personality traits.  And I will compare my observations to the information on each questionnaire to try to determine the most appropriate home for each puppy by matching the needs of each individual dog to each prospective owner’s lifestyle.

Therefore, the answers you provide in this questionnaire are vital in assisting me to match your home with the right puppy.  There are no “right” or “wrong” answers.  Some of the questions may seem personal; however, candor and honesty are very important—remember, you're asking me to trust you for the lifetime of the dog.


PROSPECTIVE BUYER INFORMATION
 Name: 
Address: 
Home Phone: 
Work Phone: 
Cell Phone: 
E-mail address:  

GENERAL INFORMATION
 Why do you want a dog?

Are you acquiring a dog for yourself or for someone else?
             If for someone else, are they aware of your intentions, or is the dog to be a surprise?

Do you have children living with your or visiting regularly?  
             If yes, please note gender and ages.
             Are you prepared to teach any resident or visiting children the proper way to conduct themselves around dogs?


How do others in your household (spouse/significant other, parents, children, etc.) feel about the addition of a Belgian Tervuren?

Who in your family will be primarily responsible for:
             daily care of the dog
             clean up
             training
             exercise
             vet and food bills

How would you describe your household activity level? 
             Very quiet
             Rather easygoing
             Usually something going on
             Lots of activity

How did you learn about Belgian Shepherds?  

Why do you want a Belgian Tervuren?

Have you considered other breeds? 
             If yes, what breed(s) and why?

For each dog you currently own, please list the following:
             Name – Breed or mix – Sex – Age – Is pet spayed or neutered?

For each dog you have owned in the past 10 years, please list the following:
             Name – Breed or mix – Sex – Age – Was pet spayed or neutered? – Why do you no longer own the animal? 
             (If deceased, please give age at death and cause of death.)

Do you have other pets? 
             If yes, please list.

Do you regularly read any dog magazines? 
             If yes, please list.

Have you read any dog health or training books? 
             If yes, please list, and describe your general thoughts about these books?

Have you or anyone in your household ever been charged with animal cruelty?
             If yes, please explain.
Have you or anyone in your household ever had any animal taken away for suspicion of animal cruelty?
             If yes, please explain.
Have you or any person in your household ever had privileges suspended by the American Kennel Club, the United Kennel Club, the Canadian Kennel Club, or any other such club?
             If yes, please explain.



LIVING ARRANGEMENTS
Do you live in:
             apartment
             house
             mobile home
             condo
             other (describe)

In which type of area is your home located?
             urban
             suburban
             rural

Do you own your home or are you renting?  
Do you have a fenced yard?
             If yes, size of yard, type and height of fencing.
             If no, please explain what arrangements you will provide for housebreaking and for safe and adequate exercise.

Are there any dog restrictions or laws in your area? 
Have you checked into local ordinances in your area pertaining to owning/housing an animal (e.g., leash laws, required vaccinations, dog licenses, etc.)? 
Are you willing to comply with any such laws?

Have you ever used a crate in housetraining a puppy or dog?  
             Do you intend to use a crate for this dog?

If you have to be away from home for a few days and are unable to take the dog, what arrangements will you make to provide for his/her care?

What will you do with the dog when you go on a vacation trip?

 In the event of emergency (e.g., hospitalization, natural disaster, etc.), who would take care of your dog?  

If you were to move, what would happen to your dog?When you travel with the dog, where will he/she ride?

How do you envision a dog fitting into your home (schedule, indoor/outdoor activities, exercise, etc.)?

Where will the dog spend most of his/her time? 
             Where will the dog be when you are at home? 
             How long each day will the dog be alone?   
             Where will the dog be when you are away? 
             Where will the dog sleep?


YOUR INTERESTS/GOALS
 Are you interested in a puppy, an older pup, or an adult dog?

Would you prefer to have a female or male dog?

Please describe any physical attributes that are of particular importance to you in the puppy/dog you are seeking at this time?

Are you prepared to spay/neuter your dog, or are you interested in breeding?

What are your goals for your dog?  (Please check all that apply.)
             Companion (pet)       Conformation/Showing          Agility                              Herding             
             Obedience                  Rally                                           Tracking                         SAR
             Therapy Dog               Assistance Dog                       Messenger Dog           Flyball
             Schutzhund                (Other (specify)

Please describe any character attributes which are of particular importance to you in the puppy/dog you are seeking at this time?

What do you expect of your Belgian?

What do you expect of your dog’s breeder?


GROOMING, EXERCISE, AND TRAINING
 Are you aware of the grooming requirements of the Belgian Shepherd?
             Are you prepared to spend the required time grooming your Belgian Shepherd?

In addition to the normal routine at home, what activities will your Belgian have?
             Walk routinely with a family member
             Go to classes
             Compete in dog shows or performance events
             Go to your place of business with you
             Travel with you
             Be a playmate for your children
             Be a playmate/companion for other pets
             Other (specify)

Do you belong to any dog or dog sports club(s)?  
             If yes, please list.

Have you ever trained a dog?  Attended training classes?
             If yes, please describe how you trained and what commands were taught.

How do you intend to obedience train your Belgian?   (On your own?  With a club/trainer?  What commands will you teach and what training methods will you use?)

Are you aware of the SOCIALIZATION AND TRAINING requirements of the Belgian Shepherd?

Are you prepared to spend time SOCIALIZING AND TRAINING your Belgian Shepherd?  

Have you ever experienced any behavior problems with past or present pets? 
             If yes, how did you handle those problems?



OTHER
 Are you prepared for the responsibility of caring for this dog for its entire life (10-16 years)? 

How did you learn about Genesis Belgians?

May I or my representative visit your home? 
   If no, why not?

Please add any additional information or thoughts that you feel would help me to understand you as a potential Belgian owner and the home you can offer the dog.

What questions do you have for me?



VETERINARIAN INFORMATION / REFERENCES
If you have a veterinarian, please provide contact information below
   Name
   Address
   Phone
   E-mail

Please supply two references (dog trainers, Belgian owners, friends, neighbors, etc.—not including immediate family) who know you well enough to recommend you as a good dog owner.
    Name
    Address
    Phone
    E-mail
    Relationship to you

   Name
   Address
   Phone
   E-mail
   Relationship to you

By signing/submitting this questionnaire, I affirm that all statements made above are true to the best of my knowledge.  (If you are submitting this form via e-mail, please type your name in the signature line.  I will require a signed copy before placing a puppy.)

Name
Signature
Date



Powered by Create your own unique website with customizable templates.