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Name:_______________________________________________________________
Home Phone No.______________________________________________________
Address:____________________________________________________________
Work Phone No.______________________________
City/State/Zip Code:_______________________________________________
Date________________
Email Address:_______________________________________________
Sire/Dam of Litter:_________________________________________________
Date:_____________Deposit of $__________ Sent__________Received__________
1) How did you hear about us?
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2) What made you decide to get a dog of this breed?
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3) Do you have a preference for a male or female?______________ If so, why?_____________
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4) Color preference:________________________________________________________________
5) Size preference:_________________________________________________________________
6) Have you ever owned a dog before?________ What breed(s)?____________________________
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7) Is there someone home during the day?________
If not, how do you propose to care for a young pup?___________________________
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8) Do you have children?_______ What ages? _________________________________________
9) Do you currently have any other dog(s)?________ Breed(s), age & sex:_________________
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Other pets?______________________________________________________________________
10) Do you have a fenced in yard?________ If not, how will you exercise the dog?________
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11) Have you ever used a dog crate for housebreaking/training a pup?_____________________
At age 7 weeks we individually temperament test each pup in the litter. Please answer the following to help us make the best match:
My (our) home is best described as:
___ a) fairly quiet - low noise and activity level
___ b) moderately active
___ c) quite busy - lots of people/kids in and out, high noise level
Outside activities with a dog would include (check all that apply):
___ occasional short walks
___ daily walks for__________(approximate amount of time)
___ playtime in a fenced yard
___ jogging/running for__________(distance) or__________(amount of time)
___ dog park visits__________times per month
___ Frisbee
___ hiking/camping
___ swimming in a ________ pool ________ pond, lake
___ accompanying family to kids' sports games
Would you be interested in:
___ Obedience Classes
___ Obedience Competition
___ Agility Classes
___ Agility Competition
___ Therapy work at a hospital/nursing home
There will be times when your pup will misbehave (housebreaking accidents, chewing objects, nipping at people, etc). Would you tend to:
___ confine him to his crate for "time out"
___ ignore it at this young age
___ distract him with his own toy
___ scold him in a stern tone
___ give a physical correction ( a scruff shake or smack as needed)
All pups are playful (regardless of temperament). Do you want your adult dog to:
(Please check all that apply)
___ quietly lay on his rug or at your feet unless invited to interact
___ beg you to go for a walk or play ball
___ follow you around wherever you move in the house
___ be more independent
___ be more affectionate, a cuddler
___ be submissive
___ be laid-back, quiet & calm
___ be the leader of the pack
___ be able to tolerate noise
___ easily adapt to new situations
___ be very outgoing towards people
___ have a high energy level physical endurance
Please add any comments that you feel would be helpful:
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