Please download (or print off) and complete the following information and mail it to us at:

Mikatura Australian Shepherds
Box 9, Site 2, RR #1,
Eckville Alberta Canada T0M 0X0


Attach to an email to


Address:  (City, Province/State, and Postal Code/Zip)


Phone #:           Cell Phone #:                Business #:    

How did you find us? (Referral from another buyer, Breeder Directory, etc.)    

Your Age    

Other adults in your home:    

Do you have any children?    

If so, what are their ages, and have they been exposed to dogs in the past?    

Were there ever any problems with your children & dogs?    

Do all family members agree on the addition of an Aussie to the family?    

If not, who is not in favour of getting an Aussie and why?    

Who will care for this dog if you should become incapacitated, temporarily or permanently?    

Do you agree that, if for some reason you are unable to care for this dog, we will be contacted about its relocation and will have first right of refusal?    

Do you Own or Rent your home?    

If you rent will your landlord give you written permission to have an Aussie?    

What type of home do you live in (house, apartment, duplex, townhouse, farm, etc.)?    

How many hours will this dog be left alone per day?    

Where will the dog be when no one is at home?    

Does your family have enough "quality" time to devote to a dog?    

Are you willing to take responsibility for this dog for the next 10 or more years?    

How long did your last pet live and what were the circumstances of its death?    

Have you ever returned a pet to the breeder?    

If so, what were the circumstances?    

Have you ever given a pet away?    

If so, what were the circumstances?    

Have you ever given up a dog to a shelter or pound?    

If so, what were the circumstances?    

How many dogs do you have now?    

What breeds?    

Have you owned Australian Shepherds before?    

How recently?    

What is your knowledge of the Aussie, and what are your reasons for choosing one now?    

Are you aware of the socialization needs of an Aussie puppy and do you feel you are capable of providing for these needs?    

Do you have pets other than dogs?    

What are they?    

Is your yard fenced or do you have a fenced enclosure for the dog?    

If you answered "No" to the last question, how to you intend to exercise and provide security for this puppy?    

How large and of what type is the enclosure?    

Do you let your dogs run loose and under what circumstances?     

Do you intend to house your dog inside or outside?    

Have you ever used a crate to confine your dog? (By the way we do not think this is a bad thing, our dogs love their crates the odd time they go in them!)    

Are you willing to have the the puppy's eyes checked on a yearly basis?    

If you will be doing agility are you willing to have the puppy’s hips x-rayed (OFA, PennHipp or OVC clearance) before starting to compete in agility?    

Please list what area(s) of interest you plan to pursue with your Aussie? (examples: working stock, conformation, obedience, agility, pet/companion, gift, watch dog, breeding, 4-H project, trick dog)    

If you plan to work your Aussie, what type(s) of livestock will be used?    

Have you ever trained a dog for livestock before?    

Have you ever worked or handled a dog on livestock before?    

What sort of working drive do you feel would mesh with your personality, (i.e. hard, sharp, moderate, low).and why?    

Have you ever shown a dog:    

If yes, where, what venue(s) and to what extent?    

Are you willing to enrol the puppy in at least one structured obedience class?    

Colour - please indicate your preferences    

Do you prefer your dog to be male or female?    

Would you consider an older or rescue dog?    

If so, what is the maximum age you would accept    

Are you willing to travel to Alberta to meet the dam and sire of our puppies?    

If travel is impossible (and we do understand that it is in some cases) would you be willing to allow a home visit from one of our friends in your area?    

Please give us two references (name and phone number) of people that know or have known you and your dogs/pets.    

Please give us the name and number of the local agency in your area that handles dog complaints.    

Registration applications for all Australian Shepherds placed as companions will be marked as "non-breeding" except in special circumstances. Do you have any reservations about this policy?    

If yes, please tell us about your reservations    

If you are interested in breeding this dog, what are your reasons for breeding?    

If your plans are to one day breed your puppy, are you willing to have the puppy’s eyes CERF certified and hips x-rayed and submitted to either OVC, PennHip or OFA after the puppy is 24 months of age and before they are bred?    

Are you aware of some of the health problem which can appear in some Aussies today such as medication sensitivities?    

Are you aware that Australian Shepherds are medium sized and very active dogs that shed (sometimes quite profusely)?    

Are you willing to deal with these attributes that are so much a part of an Aussie?    


If you had to choose between two puppies, one with perfect conformation, but low-moderate drive, and one with so-so conformation (not as well marked as expected in a show/breeding puppy) and high drive, which one would you choose and why?    


If you had to choose between two puppies, one with perfect looks and conformation, and one with so-so looks and good conformation (not as well marked as expected in a show/breeding puppy) which one would you choose and why?    


Please provide the name, address and telephone number of your veterinarian (or one who has worked with you in the recent past) as a reference:    

Are you currently on the waiting list for any other litters?    

Have you been in contact with any other Aussie breeders concerning purchase of a puppy and if so please tell us who they are and/or what waiting lists you are on?    

Further comments: Please feel free to add anything that you think would help us in choosing the right individual for you.    


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We would like to thank you for taking the time to fill in this questionnaire. The idea behind these questions is that, knowing the pups temperament from day one, we may see different things in them than you would as a stranger attempting to pick one. In this way we may be better able to guide you toward a puppy which realistically suits your experience, needs and goals.


We make every effort to ensure that our puppies are free from any inherited defects, by screening our breeding stock for those problems common to our breed. However, due to complex genetic interactions and environmental factors beyond our control, we cannot guarantee that a puppy purchased from us will be completely free of genetic disorders. If, at any time, your Aussie is diagnosed with any health problems, genetic or otherwise, we must be notified immediately of the full details so that we can make every effort to help with the situation.  Our puppies are sold with a guarantee against monorchidism, cryptorchidism, Hip Dysplasia, Iris Coloboma, Cataracts or CEA (Collie Eye Anomoly).

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