Puppy Questionnaire First Name(required) Last Name(required) House Number (Address)(required) Street(required) City(required) State(required) Zip Code(required) Phone(required) Email Address How many adults are in your household?(required) What are their ages?(required) How many children in your household?(required) What are their ages? Who will be the primary caregiver?(required) On average how many hours will the dog be alone a day?(required) 1 2 3 4 5 6 7 8 9 10 Will there be someone who can exercise the dog during the day?(required) Yes No Have you ever had a dog before?(required) Yes No If yes, do you still have the dog? If not, please explain what happened? Does anyone in your house smoke or use vapor products?(required) Yes No If yes, inside or outside? Inside Outside N/A Do you own your home or rent? If you rent, are pets permitted?(required) I own my home I rent my home and pets are permitted. I rent my home and pets are NOT permitted. Do you have a fenced in yard?(required) Yes. It is a full tactile fence. Yes. It is a partial tactile fence. Yes. It is an invisible fence. If no, how will the dog be confined outdoors? How big is your yard?(required) Please check all that apply. I am interested in black spotted only I am interested in liver spotted only Color doesn't matter I am interesed in a male only I am interested in a female only Sex doesn't matter I plan on breeding my dog I will have my dog spayed/neutered I want to show my dog (Conformation) I want to show my dog (Performance) I am only interested in an AKC puppy I am only interested in a UKC puppy I want a healthy good tempered puppy and I really don't care whether it is AKC or UKC registered I am only interested in a LUA puppy I am interested in an adult housebroken dog I am not sure I want a dog I am mainly interested in information regarding Dalmatians Where did you hear about our breeding program?(required) AKC Marketplace DCA Breeder Referal GPDC Breeder Referal Web Search Other Do you have any other animals? Explain(required) Why did you choose this breed?(required) Have you ever returned a pet to a breeder?(required) Yes No Have you ever given a pet away or resold a pet?(required) Yes No Have you ever returned a pet to a rescue or shelter organization?(required) Yes No If you have answered yes to any of the the three previous questions, please explain the situation. Submit Share this:TwitterFacebookLike this:Like Loading...
