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Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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-
Area Code
Phone Number
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tell us a little about you, how many people reside with you.
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What is the age of the oldest family member in your home?
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What is the age of the youngest family member in your home?
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Are dog allergies a concern for anyone in your family? If yes, do you know what they are allergic to (dander, hair, saliva).
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Who will be the primary caretaker of the new puppy?
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Please tell us about your yard?
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Small
Medium
Large
Please tell us about your fence?
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Under 4 feet
Over 4 Feet
Electic
Do you currently have other animals in the household?*
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Yes
No
Please tell us a little about the other animals that live in your household.
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Who in your household is the most enthusiastic about getting a puppy? Why?
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How did you hear about us?
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Will this puppy be your first Portuguese Water Dog?
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Yes
No, we have PWDs listed above
No, we have had one in the past
Why a Portuguese Water Dog?
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When would you like to add a puppy to your life?
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Ready now!
3-6 months
6-12 months
12-24 months
More than 12 months
Exploring if a PWD is right for me
Please indicate time frame
Will this be the first dog you will solely be responsible for raising? (i.e. not a dog from your childhood home)
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Yes
No
Puppy gender?
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I want a Male
I want a female
Either gender works, I want the right puppy!
If you have a gender preference, why?
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What activities do you expect to do (or have interest in) with your NEW puppy?
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Puppy Kindergarten / Obedience
Water Work / Trialing
Obediance (advanced)
Pet-assisted Therapy
Agility
Search & Rescue
Rally
Breeding
Conformation (CKC/AKC)
Dock Diving
Barn Hunt
Service Dog (ESA / ASD/ Alert)
Tracking
Lure Coursing
Nose Scent Work
Other
Desired Puppy Traits
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On a typical weekday, in the first 6 months, how many hours will your puppy be left alone? Please describe.
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Where will your puppy/dog spend his nights? (e.g. crated in bedroom, kitchen, outdoor kennel, etc...)
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Daily Life - Week Day
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Daily Life - Week End
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In what ways do you think having this dog will change your lifestyle?
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Do you allow your current dogs or intend to allow future dogs to run off-leash? If yes, under what circumstances? If not, why not?
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Do you have a person or facility that you will use for puppy classes? (If not we are happy to help you find a reputable one)
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I understand that Robel Portuguese Water Dogs will use the information gathered to match the best puppy to my family.
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Yes
No
I understand that I must wait until at least 24 months of age to spay or neuter.
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Yes
No
I understand that I will be required to complete OFA (Orthopedic Foundation for Animals) hip and elbow X-rays when the puppy is between 24-28 months of age.
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Yes
No
I understand that I will be required to sign a legal contract prior to taking the puppy home that legally binds both Robel PWDS & the Buyer to all of our agreements.
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Yes
No
I understand that PWD puppies require regular training and I am committed to taking classes with my puppy and doing daily practice for the first year so that he will be a wonderful family member.
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Yes
No
I understand that Robel PWDs has years of knowledge/experience in PWD health and can assist my Veterinarian in making the best health decisions for me PWD.
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Yes
No
Has Covid-19 changed your daily routine? (i.e. work from home; less children’s activities; travel less). If so, how will you accommodate for your puppy when you get back to your previous routine?
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Additional Questions or Comments
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