Name:
*
E-mail:
*
Phone:
*
Mailing Address:
*
When is the best time to contact you?
*
How would you like to be contacted?
*
Is this a surprise for someone special?
*
Yes
No
How did you hear about us?
*
Vet
Friend
Returning Customer
Search Engine
Facebook
Twitter
Blogger
Other (please explain):
what other
How does the rest of your family feel about getting a puppy?
*
Does anyone in your household have allergies to dogs?
*
Yes
No
Do you have a fenced-in yard?
*
Yes
No
Do you have a family vet?
*
Yes
No
List two references (Phone & Email)
*
How would you describe your home environment?
*
How long at a time will the puppy be left alone?
*
Who will be the primary care-taker?
*
What breed of puppy are you looking for?
What color puppy are you looking for?
What gender puppy are you looking for?
What size puppy are you looking for?
What price range are you looking for?
When will you be ready for a puppy?
Have you talked to us before?
If yes, who did you speak to?
Do you plan to pick up your puppy in person?
Yes
No
Would you prefer to have your puppy delivered via Nanny Flight?
Yes
No
Will you need to have your puppy shipped by airplane?
Yes
No
Please list any questions or comments you may have:
Please enter the text from the image.
*
Submit
Should be Empty: