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Your Name
Your Email Address
Street Address
Town
State
Phone Number
Who Referred you to Hemlocks to purchase an Australian Shepherd?
Have you previously owned an Australian Shepherd?
Yes
No
If no, is this your first puppy/dog?
If no, what breed of dog did you have?
Are there any dogs, cats, or other pets in your home?
Yes
No
If yes, how many
Do you have children?
Yes
No
If so, how many and what ages?
What is the primary reason for purchasing a puppy/dog?
Companion
Family
Conformation
Agility
4H Dog/Jr. Handler Dog
Obedience
Working (Herding)
Tracking
Other
If Other, please explain:
Do you have a fenced yard that is secure, or an area where your
Yes
No
puppy/dog can be safe and protected while you are away?
Do you have a veterinarian?
Yes
No
If yes, please give the name of the veterinarian.
Will you have your dog spayed or nuetered?
Yes
No
Please comment on how you envision living with your new puppy/dog
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