The following questions are being asked so that the right puppy and the right placement of each puppy is made by bringing the various requirements of both the puppy and new owner(s) into perspective, BEFORE a choice is made. I hope you will agree that the animal's welfare must be my foremost consideration in considering a placement. Please answer the following questions as completely as you can, and return this form when you have finished.
1 Name: Address: Phone (home): work:
2 Referred by:
3 What reference materials on this Breed have you read?
4 How many individuals of this Breed are you acquainted with?
5 Type of dwelling: house flat mobile home/caravan
6 If renting, please give name and phone number of landlord:
7 Name, address and phone number of your veterinarian:
8 Who will be the primary care giver?
9 Where will the puppy sleep at night?
10 Where will the puppy be kept during the day?
11 Is anyone home during the day?
12 How many hours a day (on average) will the puppy be left alone?
13 Will there be someone available to feed, toilet and exercise the puppy during the day?
14 Have you ever owned a dog before? If yes what breed?
15 Do you have any other animals? If yes what are they?
16 Do you have any children? If yes, what are their ages.
17 Does anyone in your household have allergies to animals?
18 If yes, to what and how severe?
19 Are you interested in a male or female puppy? Why is that your preference?
20 At what age do you wish to get the puppy?
21 Have you considered an older dog instead of a puppy?
22 How did you hear about this breed?
23 What do you expect the activity level of this breed to be: very high high moderate below average
24 What kind of floor surfaces will the dog be on in the house?
25 How many hours a day will the puppy be kept outside?
26 How will he/she be confined when he is outside?
27 Do you have a fenced yard or suitable pen?
28 Have you ever house trained a dog before?
29 How long have you lived at this address?
30 Will you be attending any training classes?
31 If yes, when will you start, which activities or competitions are you interested in, who is the trainer?
32 How long did your last pet live? What were the circumstances of its' death?
33 Have you ever returned a pet to the breeder? If so, what were the circumstances?
34 Have you ever given a pet away? If so, what were the circumstances?
35 Have you ever taken a pet to a pound or shelter? If so, what were the circumstances?
36 Are you interested in showing the dog in the conformation ring?
37 Have you ever shown a dog to it's championship?
38 Are you interested in competition in performance events such as obedience, agility?
39 Have you shown a dog to any performance title?
40 Do you intend to breed the dog?
41 Will you have the animal desexed? If yes at what age?
Purchase/Sale approved declined
Signature of prospective purchaser:
Witness: Print Name and address:
Signature of Breeder:
Witness: Print name and address:
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