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The length of this questionnaire is extremely important in selecting the correct Samoyed for you, and or your family. All Samoyeds have unique qualities and personalities. According to your expectations and the nature of your environment in which he or she will be residing in, we work with you to ensure that this transition of your new addition is in the best possible interest for you and you’re Samoyed. Please try to answer as much as you can.
Thank you in advance. I look forward to speaking to you:
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Agree
Disagree
No Opinion
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Full Name:
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Email Address:
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Website:
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Phone Number Where You Can Be Reached:
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Best Time I Can Call You:
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AM
PM
Any
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Please Provide Your Complete Home Address:
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Occupation:
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Do You Plan On Crate Training (To Help With Housebreaking, Training, & To Provide A Safe Secure Den When Your Samoyed Can't Be Supervised):
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Yes
No
Considering
Still Researching
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Do You Have A Veterinarian? If So Name & Telephone:
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What Are You Seeking:
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Baby Samoyed Puppy 8-12 Weeks
Baby Samoyed Puppy 4-12 Months
Adult Samoyed
Undecided
Rescue
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Your Prefered Gender:
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Male
Female
Either
Would Like To Discuss
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Which Best Describes Your Hopes & Objectives For Your New Samoyed (Please Check All That Apply):
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Personal Companion
Conformation Show Dog
Breeding
Maybe Breeding
Dog For The Kids
Surprise Present
Agility
Obedience
Flyball
Herding
Sledding
Pack Hike
Weight Pull
Carting
Tracking
Skijoring
Service & Therapy Work
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Which Best Describes Your Aspirations:
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I'm Not Interested In Breeding
I Might Want To Breed
I Might Want To Show & Breed
I'm A Breeder
I Want To Be A Breeder
I Want To Be A Handler
I'm A Breeder, Owner, Handler
I Want To Be A Breeder, Owner, Handler
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Are You Willing To Obtain A Championship Title For Your Samoyed:
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Yes
No
Undecided
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Would You Be Willing To Hire A Handler:
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Yes
No
Undecided
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If Your Samoyed Turns Out To Be A "Specials" Quality - Will You Be Willing To Campaign Your Samoyed:
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Yes
No
Undecided
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Have You Ever Owned Or Fostered A Rescued Animal. Please Describe Details:
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Please Describe Your Experience, Including Any Titles Or Achievments Earned. Number Of Litters Whelped & Or Raised, Or Just General Information About Your Experiences With Dogs:
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My Ideal Samoyed Would:
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Be A House Dog
Go Out Only With The Family
Spend Time Living Indoors & Outdoors
Be Mostly An Outdoor Dog
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How Long Would You Be Leaving Your Samoyed Alone While At Work, School, Or When You Go Out:
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Where Will Your Samoyed Be Staying During The Day, Night, When You Go Away:
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If You Don't Crate Train What Other Method Do You Plan To Use:
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Do You Beleive You Can Trust A Well Trained Samoyed Alone Uncrated:
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Yes
No
Eventually
Depends
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Would You Be Willing To Take Your Samoyed To Obedience Classes & Train Him/ Her To Be A Good Canine Citizen (CGC:)
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Yes
No
None In My Area
No Time
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My Idea Of Grooming Is:
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Weekly Brushing & Or Line Combing
Daily Brushing & Or Line Combing
Shave When Necessary
Full Groom Every 4 Weeks
Full Groom Prior To Shows
Full Groom Bi-weekly Prior To Shows
Full Groom Of Bath, Blow Dry, Fluff, Nails Every 3 Months
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What Type Of Residence Do You Currently Live In:
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City/ House
City/ Condo
City/ Apartment in House
City/ Apartment Building
Country/ House
Country/ Condo
Country/ Apartment
Country/ Apartment in House
Farm
Other
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Do You Rent Or Own:
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Rent
Own
Live With Parents
Planning On Buying A Property Soon
In Contract To Buy A Property
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Do You Have A Swimming Pool:
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Yes Pool
Yes Fenced Pool
No Pool
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How Will You Safely Contain Your Samoyed:
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Secure 5' or Higher/ Fenced Yard
Secure Under 5'/ Fenced Yard
Planning To Install A Fence
Planning To Use Electric Fence
Have A Kennel Run
Will Buy A Kennel Run
No Fence - I Will Walk My Samoyed
No Fence - I Will Visit A Friend/ Relative
No Fence - I Will Use A Tie Out
I Will Go To A Dog Park
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If Applicable Is Your Gates Padlocked:
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Please Describe Your Family Situation:
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Single
Couple
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Do You Have Any Children Of Your Own:
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Yes
No
We Are Planning To Have Children
Our Children Are Grown & Have Their Own Residence
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If You Have Children, Please List How Many Along With Sex/ Ages:
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Do You Have Young Grandchidren, Nieces, or Nephews:
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Yes
No
Maybe In The Future
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Have You Researched The Samoyed Breed & Do You Feel It's Character Well Suits You & Your Families Lifestyle:
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Yes
Yes I Have Owned/ Or Own One
No
Undecided
Would Like To Discuss
Still Researching
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If Yes Why? If Undecided, Would Like To Discuss, Or Still Researching - Please Explain So That I May Address Your Concerns:
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Please Describe What Type Of Personality You Are Anticipating In Your Samoyed As Both A Puppy & Adult Dog. The Type Of Family Environment In Which He/ She Will Be Living.
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Do Other Members Of Your Household Also Want To Get A Samoyed:
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Yes
No
Mixed Opinions
N/A
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Does Anyone In Your Household Have Asthma or Allergies? If Yes Please Explain:
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Does Anyone In Your Household Have A Fear Of Dogs (Please Check All That Apply):
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Yes
No
Don't Know
Only Big Dogs
Only Dogs That Growl
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Who Will Be The Primary Caretaker? Is This Person Aware Of The Time & Energy Required To Take Care Of A Samoyed & Willing To Accept The Responsibility:
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How Would The Caretaker Handle A Situation In Which A Visitor Had A Fear Of A Samoyed:
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My Perception Of A Samoyed Is That They (Please Check All That Apply):
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Shed
Bark When Bored
Dig When Bored
Are Friendly Social Dogs
Are Guard Dogs
Jump When Excited
Need Little Supervision
Are The Perfect Breed
Are Highly Intelligent
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What Leisure Activities Or Hobbies Do You & Other Members Of Your Houshold Enjoy:
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Do You Have Or Have You Owned Other Pets:
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Yes
No
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IF YES - Please Describe Details of Any Current Or Previous Pets (All Species), Including Their Names, Ages. Health, How Long They Lived (If Deceased) What Your Favorite Traits Were/ Are. What You Would Have Changed If Given The Opportunity. Please Include Any Registered Names:
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Have You Ever Had To Put A Pet To Sleep (Euthanasia):
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Yes
No
I Would Never Do It Nature Should Take It's Course
I Would Do It If It Eliviated Pain & Suffering
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Do You Have Objections To Spaying/ Neutering Your Samoyed At 5-6 Months Old:
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No
Yes
May Consider
N/A - I Want A Altered Puppy or Adult
OK After One Litter
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Were Any Of Your Past Dogs Spayed or Neutered:
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Yes
No
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Why Or Why Not Regarding The Above:
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Are You Committed To Caring For Your New Samoyed For His/ Her Lifetime (Average 11 - 13 Years) Or Longer:
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Yes
No
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If Your Samoyed Became Sick Or Injured And You Could Not Afford The Veterinarian Bill - What Would You Do:
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If You Or A Family Member Became Ill or Lost Your Income, Or Developed Allergies What Would You Do:
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What Would Cause You To Give Up Your Samoyed Or Any Other Animal:
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Have You Ever Had To Take An Animal To The Shelter Or Pound - Please Give Details:
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Have You Ever Sold Or Given A Pet Away? Please Give Details:
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Are You Aware Of The Vaccine Debate? If So What Is Your Opinion On All The Controversy:
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How Did You Hear About Us:
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Anything Else That You Would Like To Add:
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