Protégé Belgians Puppy/Dog Application

This application helps me get to know you and what you are looking for in a dog. We may have already discussed some of it already. If you have any questions or concerns please reach out.

Name

First NameLast Name

Home Phone

Address

Cell Phone

Email address

example@example.com

Why do you want a dog? And why this breed?

What experience do you and or your household have with Belgians?

Are you acquiring a dog for yourself or for someone else? If for someone else are they aware of it?

Do you have children living with you or visiting regularly? If yes, please note gender and ages.

Are you prepared to teach any resident or visiting children the proper way to conduct themselves around dogs?

How do others in your household (spouse,significant other, parents,children, etc) feel about the addition of a dog?

How would you describe your household activity level? (Very quiet, Rather easygoing, Usually something going on, Lots of activity)

Do you have other pets? If yes, please list.

Have you ever had to rehome a pet? If so please explain.

Do you own your home or are you renting?

Do you have a fenced yard? If yes, size of yard, type and height of fencing. If no, please explain what arrangements you will provide for housebreaking and for safe and adequate exercise.

Have you checked into local ordinances in your area pertaining to owning and housing an animal? For example leash laws or required vaccinations, dog licenses, etc.

Are you willing to comply with any such laws?

If you have to be away from home for a few days and are unable to take the dog what arrangements will you make to provide for his/her care? Example: boarding, dog walker, friend.

In the event of emergency (hospitalization, natural disaster, etc) who would take care of your dog?

We do have a return clause in our contract as well.

If you were to move what would happen to your dog?

When you travel with the dog where will he/she ride?

How do you envision a dog fitting into your home? (schedule, indoor/outdoor activities, exercise, etc)

Where will the dog spend most of his/her time?

Where will the dog be when you are at home?

How long each day will the dog be alone?

Where will the dog be when you are away?

Where will the dog sleep?

Please describe any attributes that are of particular importance to you in the puppy/dog you are seeking at this time

Are you prepared to spay/neuter your dog when they are of an appropriate age?

What are your goals for your dog? Please check all that apply.

Use this to tell us more about what your looking for. Drives, temperament, hopeful plans ect.

Have you ever trained a dog? Attended training classes? If yes, please describe how you trained and what commands were taught.

For example; balanced training, force free, ect. Basic obedience like sit, recall, stay, heel, ect.

Do you belong to any dog or dog sports club(s)? If yes, please list.

Do you have a trainer and or club already lined up? If so please list.

Are you aware of the SOCIALIZATION AND TRAINING requirements of a puppy?

Are you prepared to spend time SOCIALIZING AND TRAINING your puppy?

Have you ever experienced any behavior problems with past or present pets? If yes, how did you handle those problems?

Are you prepared for the responsibility of caring for this dog for its entire life? (9-13 years)

If no why not

May I or my representative visit your home? If no, why not?

What questions do you have for me

What questions do you have for us? Any other notes you would like to include.

VETERINARIAN INFORMATION / REFERENCES

If you have a veterinarian, please provide contact information below Name

Name

Address

Phone

Email

example@example.com

Please list 2 references or more with name, phone number, email and preferred contact method.

By signing/submitting this questionnaire, I affirm that all statements made above are true to the best of my knowledge. (If you are submitting this form via e-mail, please type your name in the signature line. I will require a signed copy before placing a puppy

Signature

Date