Puppy Adoption Form

Backcountry Berners Puppy Application

Thank you for considering Backcountry Berners for your next happy, healthy Bernese Mountain dog puppy! Please complete the form below. All forms will be reviewed and followed up with an informational zoom meeting.

Prospective Pet Parent*

First NameLast Name

Prospective Pet Parent*

First NameLast Name

Preferred puppy gender?*

FemaleMaleEither

Email Address*

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Do you own any pets?*

Pet Name(s)

Pet Breed(s)

Pet's disposition and behavior towards other dogs?

Please provide your veterinarian's name and phone number:

Do you own or rent your home?*

OwnRent

If you rent, what is your landlord's pet policy?*

If you rent, please provide your landlord's information here:*

Do you have a roommate?*

YesNo

If yes, what is the contact information for your roommate?*

Do you have a yard?*

YesNo

If "Yes" to the above, is it fenced? please describe

Have you ever surrendered a pet you own to any animal shelter including a "low" or "no kill" shelter?*

YesNo

Are there children in the home? (If yes, please list ages)*

If you answered "Yes" to the above question, please provide detail:

How many hours per day would the pet be alone?*

Will you crate your pet?*

If you have to leave town, emergently or planned, where would your pet stay?*

How would you deal with behavioral issues such as barking, chewing, destructive behavior, bathroom accidents indoors, unruly leash behaviors in your pet?*

Please provide the names, emails, contact numbers, and relationship to you for 3 personal references (note: please do not use relatives as references):*

Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?*

YesNo

If you answered "Yes" please provide a detailed description:

Additional comments, questions, and/or anything else you would like for us to know!

By clicking the submit button, I have confirmed my interest in one of your puppies. I understand that this form is the first step in a puppy application process. No deposits will be taken at this time. This form will be followed by an informal zoom meeting and reference checks.

Signature of Potential Pet Parent*