Date:

Personal Information:

Your Name (required)

Your Email (required)

Complete Mailing Address:

Home Phone Number:

Cellular Number:

Occupation:

Questionnaire:

1. What made you decide on a Nova Scotia Duck Tolling Retriever (or Toller as
they are affectionately called)?

2. From what source did you learn about our kennel?

3. Have you owned dogs before?

YesNo
If Yes, what happened to them?

4. Do you have any personal experience with tollers?

YesNo
If yes, please explain:

5. Where do you live? (Check all that apply)

HouseApartmentDuplexTownhouseOtherRuralSmall TownCity

6. Do you own or rent?

OwnRent

7. Who will the puppy be sharing a home with?


If there are children, what are their ages?

8. Do you have any other pets at this time?

YesNo
If Yes, please list:

9. Does anyone in your household have allergies to animals?

YesNo
If Yes, please explain which allergies and severity:

10. Is someone home during the day?

YesNo
If No, what kind of arrangements will you be making for your new puppy?

11. Will your dog be a house dog or an outside dog?

House DogOutside Dog

12. Do you have a completely fenced yard, or a large secure enclosure?

YesNo
If No, are you willing to make a large secure enclosure? Please explain:

13. What is the name, address, and phone number of your veterinarian?

Veterinarian’s Name:

Clinic Name:

Clinic Address:

Phone Number:

14. Do you plan to have your dog spayed/neutered?

YesNo
Why or Why Not?

15. Are you aware of the specific health concerns of this breed?

YesNoWould like more information

16. Would you be willing to let your dog compete in conformation to achieve a
Championship status? (Note:He/She cannot be shown if neutered.)

YesNo

17. Are you interested in breeding?

YesNo
If Yes, are you prepared to make a commitment to always do so with the best interests of the breed in mind (join CKC/National Toller Club/follow COE)?

YesNo

What is your experience with dog training?


What do you plan to do to train this dog?

Plan to attend puppy/obedience classesPlan to train the dog yourself

19. Do you plan on participating in any of these official events with your toller?

Check all that apply:
Competitive ObedienceShow/Breeding ProspectHunting DogTherapy DogAgility/FlyballPetTrackingRallyOther
If other, please explain:

20. Is everyone in your household in agreement with getting a puppy, in particular a toller?

YesNoUndecided

21a. Do you plan on crate/kennel training your puppy?

YesNoUndecided
21b. Do you understand how this method works?
YesNo

22. When would you ideally like to be able to get a puppy?

23. Do you understand that you are making a commitment for the dog’s whole life
which could be up to 15 years?

YesNo

24. What will you do with you toller when you go on a holiday?

25. Are you aware that tollers are a high-energy sporting breed and are very active
dogs requiring plenty of exercise?

YesNo
How will you take care of their needs?

26. Are you prepared to properly vaccinate, provide any other necessary veterinary treatment, feed a high quality food, license your toller as per your areas requirements, and never allow him/her to be a neighborhood nuisance?

YesNo

27. Do you agree to have your dog OFA Hip Dysplasia evaluated and CERF eye exam done at the age of 2 years in order to have the results available to the Toller Health Data base to aid in maintaining the integrity of the breed?

YesNo

28. Would you like a male or a female or would you prefer to take either sex of puppy that we feel best suits your family’s requirements?

Prefer MalePrefer FemaleEither Sex

29. Are you willing to keep us informed of your puppy’s progress with regular updates and photos?
YesNo

All information is treated with the utmost confidentiality and will not be passed to anyone without your permission.

I have read and agree to the terms and conditions and would like to be placed on the wait list.

Upon Submitting you will be placed on our wait list. Please make sure to let us know if you should get a puppy or change your mind so our waiting list will be current.

To submit please enter the following code:

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If you are having any issues with submitting the questionnaire, please feel free to download the following PDF file and print then send to Readyfor Tollers: Readyfor Questionnaire PDF Version

OUR ADDRESS:

Readyfor Tollers
3821 Killarney Street
Port Coquitlam, BC
V3B 3G5