Questionnaire
Name:
Address:
Email Address:
Home Phone:
Cell Phone:
Best "Reach Number":
Are you married?:
How many adults live in your home?:
Do you have children? Names & Ages:
Do all members of the family want a puppy?:
Do any family members have allergies to dogs?:
Who will be the primary caregiver for the puppy?:
Name and phone number of your veterinarian::
Have you ever owned a dog before? What breed(s)?:
Do you currently have any other pets?:
Do you live in a house/apartment/condo/townhouse?:
Do you have a yard? If not, how do you plan to exercise the dog?:
Is your yard completely fenced with a secure "physical" fence or invisible fence?:
If not, would you be willing to do so?:
Are you planning to use a crate?:
Is this your first puppy?:
Are you willing to take your puppy to obedience class?:
Is anyone home during the day?:
Will someone be available to feed and exercise the puppy during the day?:
Where will your puppy stay when you are out of town?:
Please check off the following:: Family Companion Other Pet Therapy Potential Breeding Animal Potential Obedience Dog Potential Show Dog
If this is a show prospect puppy, please list references (i.e. breeders, handlers, trainers, etc.):
Have you ever bred dog(s) before?:
Rank of Importance to you (1 being most important):
Male:
Female:
Fawn:
Red:
Brindle:
Please type the text below:
