Fleur de Renard Beaucerons
Puppy Questionnaire
Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number
*
Please enter a valid phone number.
Other Phone Number
Please enter a valid phone number.
Puppy Preference
Color Preference
*
Black and Rust
Harlequin
Gender Preference
*
Male
Femal
Do you prefer natural or cropped ears? (Additional $350 for crop)
*
Would you like to still be considered for puppies that do not meet your above preferences exactly?
*
About Your Puppy's New Family
Will this be your first dog?
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Please Select
Yes
No
Have you ever raised a puppy before?
*
Please Select
Yes
No
Do you have other pets at home?
*
Please Select
Yes
No
If yes to the above, what kind and how many pets do you have?
Do you already have a veterinarian?
*
Please Select
Yes
No
If yes to the above, please list the name of your veterinarian or the name of the practice you are established at.
What do you plan on doing with your new dog? Checking the boxes indicate that you plan on titling and/or competing in that venue.
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Yes
No
Interested, but unsure
Conformation
Rally
Obedience
Agility
Dock Diving
Fly Ball
Barnhunt
Scent Work
Herding
IGP
Mondio
French Ring
SAR
Family Pet/Companion
Breeding
If you are interested in other venues that are not listed above, please tell us about them here.
Puppy/Dog Housing
We understand that circumstances can change, just tell us about your current housing.
Type of housing.
*
Please Select
Apartment
Condo
Single Family Residence
Multi Family Residence
Other
If you answered "Other" to the above question, please explain here.
Do you
*
Please Select
Own
Rent
Rent-to-own
Other
If you answered "Other" to the above question, please explain here.
Do you have fenced in yard or secure outdoor kennel?
*
Please Select
Yes
No
Not yet
No, but we do have a dog play area
Are any members of the household current members in the US Military?
*
Please Select
Yes
No
How many adults are in your home?
*
Please Select
One
Two
Three, or more
How many minor children are in your home?
*
Please Select
One
Two
Three
Four, or more
None
How many children under the age of two are in your home?
*
Please Select
None
One
Two
Three, or more
Are all adults in the home on board with bringing home a puppy?
*
Please Select
Yes
No
Does anyone in the home have allergies to dogs?
*
Please Select
Yes
No
Where will the puppy spend most of its time?
*
How will the puppy be trained?
*
Please Select
By Yourself
Puppy Classes
Professional Trainer
Will you be crate training your puppy?
*
Please Select
Yes
No
Will your puppy be an indoor or outdoor dog?
*
Please Select
Indoor
Outdoor
How many hours will the puppy be left alone (without a potty break) durring the day?
*
Please Select
Less than four hours
Four to nine hours
Nine to twelve hours
Twelve or more hours
Is this puppy being purchased as a surprise or gift?
*
Please Select
Yes
No
Have you, or anyone else in the household, ever been arrested, charged of, or convicted for animal crulety, neglect, or hoarding?
*
Please Select
Yes
No
I check records for each adult in the household
Ownership Commitment
This litter will be able to go home on a specific date. Will you be able to take this puppy home within 2-3 days of this specific date?
*
Please Select
Yes
No
Will you be able to pick up your puppy in person in Cincinnati, Ohio or Sanders, Kentucky?
*
Please Select
Yes
No
Are you planning on using ground or air transport to recieve your puppy?
*
Please Select
Yes
No
Maybe
Do you agree to give us follow up reports and/or photos from time to time?
*
Please Select
Yes
No
We love to see how our puppies and puppy buyers are doing together!
Do you agree to contact us first in the case of needing to rehome the puppy for any reason?
*
Please Select
Yes
No
Do you understand that puppies sold as companions only are placed under AKC Limited Registration? This means that the dog is eligible to be registered, however, none of their offspring will be eligible for registration. A dog with Limited Registration, as well as any altered dogs, are eligible to participate and compete in all AKC events with the exception of Conformation (breed) ring.
*
Please Select
Yes
No
I don't understand, but would like more information
Are you willing to take your puppy to a basic obedience classes or if able, train at home to insure that you have a well-mannered, enjoyable companion and ideally complete the AKC CGC evaluation and submit the form to AKC for recording? This is usually an additional $25 fee due and payable to AKC at the time the form is submitted.
*
Please Select
Yes
No
I don't understand, but would like more information.
When this puppy is purchased exclusively as a family companion, do you agree to have it spayed (females) after 18 months of age or no sooner than the first heat cycle or neutered (males) no earlier than 24 months of age and submit a Veterinarian Certificate to the Breeder as proof of surgery for their records?
*
Please Select
Yes
No
Do you understand the price of the puppy is $3000 and includes AKC registration, microchip, all age appropriate vaccinations/deworming, ear crop ($350 additional unless agreed to leave natural) before leaving breeder’s possession and health certificate for domestic travel. There is no price difference for Limited or Full Registration and the price of airline shipping is at the expense of the puppy buyer. Personal pickup is welcome and hand delivery may be available to be arranged at buyer’s expense.
*
Please Select
Yes
No
Please provide any other relevant information you feel would assist us in placing a puppy in your home:
Do you have any other questions you would like us to note?
Signature
*
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