NAME
STREET ADDRESS
CITY, STATE & ZIP CODE
PHONE
EMAIL ADDRESS
AGE
WOULD YOU LIKE A MALE OR
FEMALE?
MALE
FEMALE
WILL
CONSIDER MALE OR FEMALE
PLEASE DESCRIBE THE PUPPY YOU WANT, IF HE/SHE
IS AVAILABLE PLEASE INCLUDE HIS/HER NAME
What price Range do you intend on being in
when purchasing your new family member
$500-$700
$800-$1000
$1100-$1500depends
on many factors
What do you
believe would be the overall average monthly
cost of owning a new fur-baby
$10-$30
$40-$70
$80-$100$100
+
DO YOU UNDERSTAND THAT WE WILL DO OUR BEST
TO ESTIMATE THE ADULT SIZE OF YOUR PUPPY BUT
WE CANNOT GUARANTEE IT'S SIZE?
YES
NO
IS EVERYONE IN YOUR HOME IN AGREEMENT ABOUT
GETTING A PUPPY?
YES
NO
DO YOU OWN YOUR HOME?
YES
NO
IF YOU RENT, DOES YOUR LANDLORD APPROVE OF
PETS?
YES
NO
PLEASE LIST ANY PETS YOU HAVE NOW OR ARE
BUYING
LIST PETS YOU HAVE HAD IN THE PAST 5 YEARS?
WHAT HAPPENED TO THEM?
DO YOU HAVE A FENCED YARD?
YES
NO
WHERE WILL THE PUPPY LIVE DURING THE DAY?
WHERE WILL THE PUPPY SLEEP AT NIGHT?
WHERE WILL YOU KEEP THE PUPPY WHEN NO ONE IS
HOME?
DO YOU UNDERSTAND THAT OUR PUPPIES
WILL HAVE LIMITED AKC REGISTRATION
AND ARE NOT SOLD FOR BREEDING
YES
NO
WOULD
LIKE TO DISCUSS
WILL YOU AGREE TO
SPAY/NEUTER YOUR PUPPY BY 7 MOS OF AGE?
YES
NO
WOULD
LIKE TO DISCUSS
WILL YOU AGREE TO PROVIDE VETERINARY
CARE INCLUDING ROUTINE VISITS FOR
VACCINATIONS?
YES
NO
HOW DID YOU HEAR
ABOUT US?
DID SOMEONE REFER YOU TO
US?
YES
NO
IF YES, BY WHOM?
ADDITIONAL COMMENTS OR
QUESTIONS
THANK YOU FOR YOUR INTEREST!
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