Prospective Puppy Raiser Questionnaire

Prospective Puppy Raiser Questionnaire
Please answer honestly. The answer that you think we might want, may not actually be the "correct" answer.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
What is your preferred method of contact?

Phone - TextPhone - CallEmail
Household Members
Please list each member of the household. Include name, age (if minor), relationship in the household, and place of employment/occupation.
Who will be responsible for the majority of the dog's care?
Have you owned a dog previously?

YesNo
Have you owned another other kinds of animals? Please list.
Please list below any other dogs that reside in the home or visit the home on a regular basis (at least once every couple of weeks).
Please use this text box to add more relevant information from the above chart.
Are there any other animals that reside in the home (cats, birds,...) Please list below
Are you willing to allow a Project Hero Dogs representative into your home for a home interview?

YesNo
Have you ever trained a dog or puppy before?

YesNo
Briefly describe your experience:
Are you willing to bring the puppy to PHD headquarters in Jasper, GA a minimum of twice a month for puppy training and development?

YesNo
Are you willing to drop the puppy off to PHD headquarters in Jasper, GA for a weeks duration?

YesNo
Do you have experience with high drive working dogs and puppies? If so, please briefly describe:
Are you aware that mouthing, biting, and high energy is a common trait in working bred puppies?

YesNo
Have you been a foster/raiser home for us or another organization in the past? If so, please list below:
Will the dog be left home alone during the day?

YesNoSometimes
How many hours?
Do you have a fenced in yard?

YesNoPartialElectric / Invisible Fence
If you have a fence, how tall is it?
If not, are you willing to provide an outdoor kennel or trolley tie out?

YesNoNot applicable
Do you agree to keep the puppy on a leash at all times unless in a fenced in area?

YesNo
Do you agree to give the puppy daily puppy-safe excerise?

YesNo
Do you agree to crate train the puppy?

YesNo
Do you agree to take the puppy out for public exposure at least three times a week?

YesNo
Do you understand that you may be given homework to complete? This includes keeping a log book of these homework sessions.

YesNo
Do you have support of all members in the home?

YesNoMaybe
How much time are you able to commit to the daily care and training of the puppy?
When would you be able to bring a puppy into your home?
Do you have preference for a male or female puppy?

MaleFemaleNo preference
Do you have a breed preference?

Malinois/Dutch/GSDLabradorGSP/GWPNo Breed Preference
Are you aware of the financial commitment (vaccinations, food, toys, and monthly heartworm and flea and tick preventatives) that can occur when raising a future hero puppy?

YesNo
Are you aware that raising a foster puppy can be a 12 to 18 month commitment? If you have any restrictions to that time frame, please list:
How did you hear about the Project Hero Dog puppy raising program?
Why do you want to raise a future hero puppy for Project Hero Dogs?
Please type anything else that you would like to let us know in the text box below.
Questionnaire Complete!

A Project Hero Dogs representative may contact you for further information regarding part 2 of the interview process.
Should be Empty: