Name * (First) (Last)
Phone *
Email *
House # and Street *
City *
State *
Zip *
Acreage/House/Unit or Apartment?
Is your house yard fully fenced & secure? How high is the fence if you have one? *
Do you own your own home or is it a rental house?
Do you have children? If yes, what are their ages?
Do any of your children have a fear of dogs?
Does anyone in your immediate family suffer allergies to dogs?
YesNo
Do you have any health conditions/disabilities that may limit your ability to exercise a dog?
Where will your new dog sleep?
Do you object to a home visit prior to getting a puppy?
Do you work full time? (Away from home, In home, Combination of remote, please explain) *
What hours will the puppy be left alone? *
Have you owned a dog before? If yes, what breed and how long ago?
Have you ever given up or placed a dog because you were unable to keep it? If so, what was the reason? Shelter or person? *
Do you own any other pets? (List age, breed & sex)
What research have you done about the breed you are buying? Please be specific.
How long have you been searching for your puppy?
Male or Female puppy? Color Preference?
Will your puppy be desexed?
Do you plan to take your puppy to training classes?
Do you intend to insure your puppy?
What activities do you hope to do with your new dog? * (At least one selection required)
Snuggle BuddyConformationAgilityRacingObedience/RallyDock DivingSprinterBreeding
Do you do Titre Testing?
YesNoNot sure what that is
Do you practice Homeopathy/Holistic?
There is a Puppy Contract! Are you willing to agree to and sign a contract (will be provided before deposit)?
Are you willing to contact us in the event that you can no longer keep your puppy/dog, for whatever reason? Are you willing to return the dog to us or have a family member complete an application? *
Are you aware of the costs associated with keeping a dog?
Tell us anything else you think may be important about yourself.
Lastly - how did you find out about us? *