Online Puppy Questionnaire
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Email
example@example.com
How did you hear about us?
What sex are you interested in?
Male
Female
Doesn't Matter
Do you want a show pet?
Yes
No
Do you have children?
Yes
No
Please list the ages of your children
Do you own or rent your residence?
Do you have a fenced in yard?
If not, how will you provide security for your puppy when it is outside?
Is someone home during the day, or able to get home to "exercise" the puppy?
Will this puppy have regular contact with the family during the day?
Where will the puppy spend the evening?
What other breeds of dogs have you owned before?
Do you still own the dogs mentioned above?
If not, what happened to the dog(s)
Have you ever given up a dog to a shelter or pound?
If so, why?
Do you own any other pets such as birds, cats, etc.
Yes
No
If so, please list the other types of pets
Do you have a veterinarian?
Yes
No
Please give us the name, address and phone number of your Vet.
We require all of our pups to get the Kauffman's stress formula for their first year of life. Are you willing to give the Kauffman's stress formula to your pup?
Yes
No
Submit
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