Moonlight Shibas Puppy Questionnaire

Thank you for your interest in Moonlight Shibas and for taking the time to answer the following questions:
Date

MonthDayYear
Date
Name

First NameLast Name
Occupation
Spouse (if applicable)

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
If you have children living at home: names (optional) and ages
Does anyone else reside in your home?
If yes, who and are they permanent residents or temporary.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Years at this address:
Is this home
Explain if owned by other:
Type of structure
Is your yard fenced?
Where will your shiba spend a majority of its time during the day? and at night?
Do you have any plans to relocate?
Do you have other pets in your home?
If yes please provide breed/species, name, age, spay/neuter status
Have you previously owned dogs?, where are they now?
Veterinarian
If you have a veterinarian already please provide the following:
If you do not have a veterinarian already its very important to find a vet that deals with young puppies and is reputable. Talk to friends and neighbors to see where the best vet in your area is.
Have you ever raised a puppy?
Have you ever bred a litter of puppies?
Why do you want a shiba?
Have you ever owned a shiba? If yes please share.
If you have not owned a shiba, what sort of research have you done on the Shiba Inu
Are you aware of Shiba's temperament traits, prey drive & possible aggression towards other animals?
Do you have any questions about the above?
If you have previously participated in an obedience training class please provide instructor name/ class provider and type of class.
Do you plan to acquire any more animals in the near future?
I/we the undersigned agree that the information provided herein is accurate to the best of my/our knowledge. I/we are aware that the decision to sell me/us a shiba results from the information provided herein. I/we are also aware that providing misinformation on this questionnaire may result in Moonlight Shibas exercising their right to reclaim the shiba with no monies refunded to the buyer.
Signature
Signature
Should be Empty:

Thank you for your interest in Moonlight Shibas and for taking the time to answer the following questions:

Veterinarian