Upland Fields - Puppy Questionnaire
The following questions are being asked of you so that the right puppy can be placed with the right potential owner(s) by bringing the various requirements of both the puppy and his or her new owner(s) into perspective.  I hope you will agree that the puppy's welfare must be the foremost consideration in selecting the right home for that puppy.  Please answer the following questions as completely as you can, and return this form when you have finished. 
Please Note:  We do not ship puppies sight unseen.  All potential puppy owners must have a face to face meeting with us and the potential puppy before bringing their puppy home.
Name:_______________________________________________  Date:_______________
Address: ________________________________________________________________
Email Address:___________________________________________________________
Phone (home):_______________________(other): ________________________________
Referred by Breeder Referral Yes:______ No:______    Referred by Anyone else?
Referred by: ___________________________________ Phone #___________________
How did you find Upland Fields?_____________________________________________
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Why do you want a Field Spaniel?_________________________________________________________________
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Are you interested in a specific color?_________________________________________
Are you interested in a Male?  Female?  Either?_________________________________
Why are you interested in a male or female Puppy?__________________________________________________________________
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Are you looking for any specific personality traits? ______________________________
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Any other specific traits?___________________________________________________
What reference materials have you read?___________________________________________________________________
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How many individuals of this breed are you acquainted with?___________________________________________________________________

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Type of dwelling: House___________ Condo___________ Apartment __________________Other_________________________________________________
Do you have a fenced yard?_________Exercise areas?_________Explain:___________________________________________________
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If renting, please give name and phone number of landlord:________________________________________________________________
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Do you currently have a Veterinarian?__________Name of Veterinarian:__________________________________________________________
Address:___________________________________________________________
Phone No:______________________ 
Who will be the primary care giver? _____________________________________________________________________
Why is this person the primary care giver?_________________________________________________________________ 
Are you familiar with crate training?________________________________________________________________
Where will the puppy be kept during the night? _____________________________________________________________
Where will the puppy be kept during the day? ______________________________________________________________
Is anyone home during the day? _________Who:__________________________________________________________
Will there be someone available to feed, water and exercise the puppy during the day? 
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Have you ever owned a dog before?________________ Do you have any other dogs?_____  Breed/Sex of current dogs?_________________________________
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Do you have any other animals?_________________________________________
Field Spaniels require grooming.  Will you do the grooming or have someone groom for you?___________________________ 
 Do you have any children?_________ If yes, what are their ages. _______________________________________________________________________
Does anyone in your household have allergies to animals?________________________________________________________________ 
How does your dog travel in a car?____________________________________________________________________ 
What would you do if your family went on an extended vacation?________________________________________________ 
What training classes will you be attending? ________________________________________________________________________
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 Which Field Spaniel activities  are you interested in?_____________________________________________________________________
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Have you ever returned an animal to the breeder?_____________ If so, what were the circumstances?___________________________________________________________
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Have you ever given aa animal away?____________ If so, why? ________________________________________________________________________
 Are you interested in showing the dog in the conformation ring? ________________________________________________________________________
Have you ever shown a dog to it's championship? ________________________________________________________________________
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Are you interested in performance work such as
Obedience:_________ Agility:_________ Hunting:__________ Tracking:___________
Other:__________________________________________________________________
Have you trained for or participated in performance events such as 
Obedience:_________ Agility:_________ Hunting:__________ Tracking: ___________
Other:__________________________________________________________________
Have you trained/handled a dog to any performance titles?___________________________________________________________________ 
Do you intend to breed the dog? ________________________________________________________________________
Are you prepared to obtain all health clearances (eyes, hips, heart) before 3 years of age?_______________________________
Are you on any other breeder’s lists?__________________________________________
Have you made any commitments to any other breeders?__________________________