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The following questions are being asked of you so that the right puppy and the right placement of each
puppy is made by bringing the various requirements of both the puppy and his or new owner(s) into
perspective, BEFORE a choice is made. I hope you will agree that the animal's welfare must be my foremost
consideration in considering a placement. Please answer the following questions as completely as you can,
and return this form when you've finished.
Phone (home): (cell):
Type of dwelling: house – condo – apartment - mobile home
If renting, please give name, address and phone number of landlord:
Name, address and phone number of your veterinarian:
1. Who will be the primary care giver?
2. Where will the puppy be kept during the night?
3. Where will the puppy be kept during the day?
4. Is anyone home during the day?
5. How many hours on the average will the puppy be left alone?
6. Will there be someone available to feed and exercise the puppy during the day?
7. Is this puppy a surprise gift?
8. Do you have any other animals? Please list breed, age, sex as well as brand and type of
9. Do you have any children? If yes, what are their ages.
10. Does anyone in your household have allergies to animals?
11. If yes, to what and how severe?
12. Are you interested in a male or female puppy? Why?
13. What do you expect the activity level of this breed to be: very high – high – moderate – below
average How do you plan to meet these needs?
14. Do you have a fenced yard or suitable pen?
15. Will you be attending any training classes?
16. Do you plan on crate training your puppy?
17. Are you looking for a guard or attack dog?
18. Are you interested in performance events such as obedience and agility? If you already participate,
please give details.
19. Are you interested in participating in hiking and backpacking?
20. Do you intend to breed the dog?
21. What are your feelings about spay or neutering pets?
22. Do you understand that you will be required to sign an ownership contract prior to purchasing a puppy?
23. Are you willing to keep us updated on your puppy and to send us photographs?
24. Do you understand that we have first right of refusal if you can no longer keep your puppy?
25. Have you ever raised a puppy?
26. Please list your own questions or comments.
THANK YOU FOR YOUR INTEREST. If I do not contact you within 3 days, please resend form.
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