Puppy Questionnaire




City, State/Prov              

Phone Number:              

Your email address:       

Are you looking for a  Male   or  Female?   
                                   Puppy or  Older Dog?                  

This dog is to be a:     Show Prospect   Working Dog  Companion Only

To compete in:           Agility     Obedience  Schutzhund   Herding
                                   Tracking Flyball        Therapy         Other - explain below


What specific qualities are you looking for in a Dog?  

What are your goals for this Dog?

Tell us about your family:  
How many adults live in your home? 
How many children?  Ages of children
How many dogs live with you now?  
Any other pets?      

Tell us more about your family, pets, lifestyle, work schedules etc.

Tell us about your home:
Is the area that you live in Rural   Suburban   City?
Do you Own or  Rent?
Will the dogs live Indoors or Outdoors?
Will this dog have access to a fenced yard?     Yes   No
Are you comfortable crate training your pup?  Yes   No

Tell us about your experience with dogs.  List all dogs you have owned and what happened to them.
List any dog-related clubs you belong to.  List any titles that you and your dogs have achieved.
Please provide us with two references. 
If you have previously owned a dog, one of the references must be a breeder, veterinarian, or trainer.

Please include any additional information that you would like us to consider:

Are you willing to travel to pick your puppy up?   Yes   No