Puppy Questionnaire
All fields must be completed for the form to send. If Not Applicable enter N/A
Introduce yourself
Your Name
Spouse/Significant Other(s) Name
Address/City/State/Zip
Email
Telephone
Do you work outside the home?
YES (Full Time, 30+ Hours/Week)
YES (Part Time, 20 Hours or less/Week
NO
If Yes, what will you do with puppy while you are away?
Your Occupation and Employer
Spouse/Partner's Occupation and Employer
Children/Others living in the home. First Name and Age
Current Pets, (Type, Sex, Age)
Your reasons for wanting a Doberman
Companion/Pet
Show (Conformation)
Performance (Obedience, Agility, Rally, etc.)
Schutzhund or other Protection Sport
Breeding
Service/Therapy Dog
If Service/Therapy, what duties would the dog need to perform?
What is your preferred timeframe to acquire a puppy?
Yesterday!
1-3 Months
3-6 Months
6 Months to a Year or More
Do you or have you owned a Doberman? If yes, where is it now?
What Color/Sex are you interested in?
Black Male
Red Male
Male, No Color Preference
Black Female
Red Female
Female, No Color Preference
Have you owned a Show or competitive performance dog?
YES, SHOW
YES, PERFORMANCE
NO
If YES, Provide dog's REGISTERED name, Breed & Title(S).
Please tell us a bit about your lifestyle, hobbies and activity level
Where will your Doberman Live?
Indoors, in my home
Outside, in the back yard
Ourside, in a kennel
At a business
In a garage/barn
Do you have a securely fenced yard/area?
YES
NO
Type & Height of Fence (i.e. - Wood, Chain Link - 4 ft, 6 ft, etc.)
If no fence, are you willing to install one?
Do you have a swimming Pool?
YES, built In
YES, above ground
NO
If yes, is pool fenced off?
Where will your Doberman stay when you are away from home on vacation, etc.?
Do you Own or Rent your home?
OWN
RENT
Who carries your homeowner's or renter's insurance?
If RENT, Name, Address & Phone of Landlord.
Veterinary Reference (Name, Address, Phone)
Personal Reference (Name, Relationship, Phone) NO FAMILY MEMBERS!
How did you hear about us? If you were referred by someone, please tell us who, so we can thank them.
Additional information, comments, questions, etc.
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