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CONFIDENTIALITY STATEMENT: Information submitted to this survey is confidential. ASHGI will not issue reports containing specific information about any individual dog; published survey reports will be statistical in nature. We do reserve the right to share specific survey data with legitimate researchers focusing on specific health issues in our breed.
May we ... Contact you if we have further questions? Include your dog's information in the confidential International Directory for Australian Shepherd Health (IDASH) Pedigree Analysis Database? (Your dog will not be named. Information will be used to calculate pedigree risk scores only.)
May we ...
Contact you if we have further questions? Include your dog's information in the confidential International Directory for Australian Shepherd Health (IDASH) Pedigree Analysis Database? (Your dog will not be named. Information will be used to calculate pedigree risk scores only.)
Please complete one survey for each Australian Shepherd you own who lives or lived primarily with you and who was born during the period beginning January 1, 1990 and ending December 31, 2005. Co-owners should decide who has the best knowledge of the health and breeding history of the Aussie they own together, and that one owner should enter the information for the dog.
NOTE: All dates should be entered MM/DD/YYYY. If you know only an approximate date you may enter as follows: --/--/1998 or 10/--/2003
The following section is a general overview of you and your dog.
Owner Name:
Address:
City: State: Postal Code: Country:
Email Address:
Note: The word "dog" as used in this survey refers to either sex. Where specific gender is referenced, "male" and "female" have been used.
1. How many years have you owned Aussies?
Less than 1 year 1-5 yrs 6-10 yrs 11-20 yrs More than 20 yrs
2. How many Aussies currently live with you?
None at this time 1-5 6-10 11-2O More than 20
3. How many other dogs currently live with you?
4. Activities - What areas of breed activity do you currently participate with your dogs? (Check all that apply)
Activity Currently Active Active in the past Breeder Conformation Stock/Herding Trials Obedience or Rally Agility Tracking Commercial farm/ranch work Assistance/Therapy Search and Rescue Companion/Pet Other
If you marked "Other" please name the activity(ies) and indicate whether or not you are currently active.
5. Have you ever bred Aussies? Yes No If yes, please answer the following
a. Approximately how many litters have you bred?
less than 5 5 to 10 11 to 20 more than 20
b. How many litters did you breed between January 1990 and December 2005?
c. How many litters, on average, did you breed per year?
less than one 1 or 2 3 or 4 5 or more
1. Aussie's Name and Registry Info a. Call Name: b. Registered Name followed by the applicable registry: Please omit titles None If this dog is also registered under a different name with a different registry than above, please include that name below followed by the applicable registry: Again, please omit titles c. Registration Numbers American Kennel Club Australian Shepherd Club of America Other Registry - Specify: Unregistered, but out of registered parents Unregistered, parents unknown or unregistered d. Chip Number: None e. Tattoo: None 2. Aussie's Country of Birth: Aussie now lives in what country? 3. Sex: Male Female 4. Altered? Yes No If yes, Date: (MM/DD/YYYY) Reason for altering: 5. Date of Birth: (MM/DD/YYYY)
1. Aussie's Name and Registry Info
a. Call Name: b. Registered Name followed by the applicable registry: Please omit titles None If this dog is also registered under a different name with a different registry than above, please include that name below followed by the applicable registry: Again, please omit titles c. Registration Numbers American Kennel Club Australian Shepherd Club of America Other Registry - Specify: Unregistered, but out of registered parents Unregistered, parents unknown or unregistered d. Chip Number: None e. Tattoo: None
2. Aussie's Country of Birth: Aussie now lives in what country?
3. Sex: Male Female
4. Altered? Yes No If yes, Date: (MM/DD/YYYY) Reason for altering:
5. Date of Birth: (MM/DD/YYYY)
6. Dog's Height: inches OR centimeters Dog's Weight: lbs OR kilograms
7. Tail Length a. Tail length at birth (check one) Full 3/4 1/2 1/4 Very Short Absent Don't Know b. Is/was the tail kinked? Yes No Don't Know c. Was the tail docked? Yes No If yes, proceed to question 8 - Where did you obtain this Aussie? If no, please respond to the questions below, checking the best descriptions: d. Shape (Check one) --- click an image to enlarge Straight Slightly Curved Strongly Curled Curled e. Typical carriage when relaxed (Check one) --- click an image to enlarge Low Slightly below topline Level with topline Above topline Over the back f. Feathering (Check One) --- click an image to enlarge None More profuse at base and shortening toward tip Equally profuse from base to tip
7. Tail Length
a. Tail length at birth (check one) Full 3/4 1/2 1/4 Very Short Absent Don't Know b. Is/was the tail kinked? Yes No Don't Know c. Was the tail docked? Yes No If yes, proceed to question 8 - Where did you obtain this Aussie? If no, please respond to the questions below, checking the best descriptions: d. Shape (Check one) --- click an image to enlarge Straight Slightly Curved Strongly Curled Curled e. Typical carriage when relaxed (Check one) --- click an image to enlarge Low Slightly below topline Level with topline Above topline Over the back f. Feathering (Check One) --- click an image to enlarge None More profuse at base and shortening toward tip Equally profuse from base to tip
Full 3/4 1/2 1/4 Very Short Absent Don't Know
8. Where did you obtain this Aussie? Bred it myself Breeder Shelter or Rescue Pet store Newspaper ad. Given to me by a friend or family member Other
8. Where did you obtain this Aussie?
9. How old was this Aussie when it came to live with you? Under 8 weeks 8 weeks to 6 months 6 to 12 months 1 to 4 years 4 to 7 years More than 7 years Don't know
9. How old was this Aussie when it came to live with you?
10. Rate your dog’s General Health: Excellent Very Good Good Fair Poor If fair or poor, at what age did health begin to decline? Not Applicable Birth to 3 months 3 to 6 months 6 to 12 months 1 to 3 years 3 to 6 years 6 to 8 years 8 to 10 years 10 to 14 years over 14 years
10. Rate your dog’s General Health: Excellent Very Good Good Fair Poor
If fair or poor, at what age did health begin to decline? Not Applicable Birth to 3 months 3 to 6 months 6 to 12 months 1 to 3 years 3 to 6 years 6 to 8 years 8 to 10 years 10 to 14 years over 14 years
