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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
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Date of Initial Call
*
MM slash DD slash YYYY
Applicant Information
Applicant's Name
*
First
Last
Address
*
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
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Maine
Maryland
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Northern Mariana Islands
Ohio
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Rhode Island
South Carolina
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Vermont
Virginia
Washington
West Virginia
Wisconsin
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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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