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Telephone Interview Report
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Telephone Interview Report
Telephone Interview Report
Austin
2019-11-16T16:52:18-06:00
Date of Initial Call
*
MM slash DD slash YYYY
Applicant Information
Applicant's Name
*
First
Last
Address
*
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
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Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
*
Interviewer Information
Interviewer's Name
*
First
Last
Phone
*
Email
*
Enter Email
Confirm Email
The Interview
Describe the residential area.
*
City
Apartment
Suburban
Rural
Does the applicant currently own dogs?
*
Yes
No
How many?
*
Describe the dog(s).
*
Very submissive
Somewhat submissive
Somewhat dominate
Very dominate
Was the pet spayed/neutered?
*
Yes
No
Has the family lost a pet?
*
Yes
No
What happened to it?
*
Got rid of it
Died of health problems
Died of old age
Ran away
Killed in traffic
Poisoned/shot/murdered
Is the applicant interested in breeding?
*
Yes
No
Where do the applicant's dogs stay while away from home?
*
Inside in crate/gated area
Inside free to roam house
Outside fenced area
Outside in pen
Family lifestyle
*
Very active
Somewhat active
Walk occasionally
Couch potato
Will the Golden be part of the family and participate in activities?
*
Yes
No
Additional comments
Copy to interviewer
Send me a copy of this report
Phone
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