Lionheart Evaluation Form

Lionheart Evaluation Form

Thank you for showing interest in our Bernese Mountain Dogs. We would appreciate you answering the following questions which will help in assessing if we have the appropriate puppy for you and your family.
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone*

Area CodePhone Number
Work Phone

Area CodePhone Number
E-mail*
Contact Preferences
Correspondence Method*

E-mailPhone
Best time of day to reach you*

MorningsAfternoonsEvenings
Best Days to reach you

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Referred by:
Enter referral's name
Puppy Preferences
Gender*

Size preference*

	1	2	3	4	5

1 is Small, 5 is Large

What characteristics are you seeking in a BMD?*
Are you interested in a BMD for:*

ObedienceCompanionShow ProspectProtectionBreedingOther

Additional Information
Breed of dog*
Currently or previously owned
Describe what happened to these dogs.*
What animals do you have at home now?*
Are they spayed/neutered?*
Do you want a dog for breeding purposes?*
Do you have children at home?*
If Yes, indicate children's age & gender
What health issues are aware of in the BMD as a breed?*
What questions do you have about the website information?
What is your "plan of action" for exercising your BMD?*
Do you have a fenced yard?*
If Yes, indicate type of fence.
How many hours a day will the puppy be left unsupervised?*
Do you have an area to keep your puppy confined when you're not home?*
Are you willing to maintain contact with us on the development of the puppy?*
Please use the text box to add any information you wish us to consider in placing one of our puppies with you and your family. We appreciate the chance to gain a little insight into your expectations for this new member of your family. Your in-depth and honest answers help us in selecting a proper puppy for you. Thank you again for your interest in our breeding program.*
Lionheart Bernese Mountain Dogs

Amy R Kessler
E-mail
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Additional Information