New Customer Registration Form
Customer Details:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
What are you interested in? If current puppy, which one:
Color/Gender interested in:
What aspects of a Dachshund are most important to you?
Have you ever been cited for or charged with animal cruelty, abuse, neglect, or abandonment?
Do you own or rent your home?
Own
Rent
Other
If you rent, please provide your landlords Name and Phone Number:
Is your backyard fenced in?
Yes
No
If not fenced, how do you plan to exercise him/her?
Have you ever owned a Dachshund/Small Breed dog before?
Yes
No
Other
Who will be the primary care taker of the puppy?
How many animals do you own? (Please provide gender, breed, spay/neuter status)
How long will this puppy be left at home alone?
What do you plan to do with the puppy while you are gone?
Are you often away for extended periods?
Yes
No
If yes, what do you plan to do with the puppy?
Where will the puppy be when the family is home?
Do you understand that our puppies are not to be kept as outside dogs for any reason at any time, but as an integrated part of the family in the home?
Yes
No
Have you ever had a dog die in the last 3 years? (If yes, please explain why)
Do you have any children (If yes, how many and their ages)
Does anyone in the home have allergies to dogs?
Yes
No
If yes, please let us know how you plan to handle the allergy with the puppy in the home
Are you willing to spay/neuter your puppy?
Yes
No
If no, please explain...
Are you willing to take your puppy to obedience training?
Yes
No
Are you willing to crate this puppy if needed?
Yes
No
Do you understand that our puppies are sold on Limited Registration? (If you are looking for Full AKC registration, please let us know so we can discuss)
Yes
No
Are you aware of and can you afford the expenses involved in caring for a Dachshund?
Yes
No
Do you agree to ensure that your puppy gets all necessary and required vaccinations on time?
Yes
No
Do you understand that your puppy will need yearly exam and booster vaccines?
Yes
No
Do you understand what a return contract is? We do not ever want our puppies to end up at a shelter, pound, or rescue so EVERY puppy is sold on a strict return contact.
Yes
No
Do you understand that your puppy can never be sold or given away in the event that you are unable to keep it?
Yes
No
If approved for one of our puppies, do you understand that we require a $750.00 non-refundable deposit, due at the time of picking (or add to wait list), with the remaining due at 7 weeks of age?
Yes
No
If approved for a puppy with us, are you prepared to place your non-refundable deposit to hold your puppy now?
Yes
No
If approved for one of our puppies, do you understand that any and all monies paid at any point in time will not be refunded for any reason?
Yes
No
Will your puppy need to be shipped? (If yes, please advise which airport or transport company)
Please provide your veterinary information:
Please provide 3 non-family references: (Name and Phone Number)
Extra Message to Breeder:
Signature
Submit
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