Placement Questionnaire

Name

Address

Home Phone:

Work Phone:

Referred by:

Type of Dwelling:

How long have you lived at this address?

If renting, please give name and address of Landlord:

Do you have children? Ages

Who will be the primary care giver?

Where will the puppy be kept during the day?

Where will the puppy be kept during the night?

How many hours a day will the puppy be kept outside?

How will the puppy be confined when he is outside?

Do you have a fenced yard or suitable pen?

Is any one home during the day?

How many hours, on the average, will the puppy be left alone?

Will there be someone available to feed and exercise the puppy during the day?

Have you owned a dog before?

Do you have any other animals?

Does anyone in your household have allergies to animals?

If yes, to what and how severe?

Are you interested in a male or female?

Are you interested in showing, breeding or a family pet

Would you consider an older dog instead of a puppy?

How did you hear about this breed?

Have you ever met one in person?

Have you house trained a dog before?

Will you be attending any training classes?

How long did your last pet live?

What were the circumstances of its' death?

Have you ever returned a pet to the Breeder?

What were the circumstances?

Have you ever given a pet away. Why?

Have you ever taken a pet to the pound or shelter? Why?

Are you willing to sterilize the dog?

What else can you tell me about you and your family.

Email Address