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Puppy Application Questionnaire

This brief questionnaire will help us with matching you with the best possible puppy.
Email address *
All information gathered here is strictly confidential and will not be shared.
Today's Date *
Your Name *
Your answer
Your Address
Your answer
Your Email *
Your answer
Best telephone # and time to reach you
Your answer
Referred by:
Your answer
Type of dwelling:
Name, address and phone number of your veterinarian:
Your answer
How many hours on the average will the puppy be left alone? *
Your answer
Do you have a securely fenced yard? *
Do you have any children? If yes, what are their ages. *
Your answer
Will your puppy live indoors or outdoors? *
Are you interested in a male or female puppy?
What color puppy are you most interested in? *
Are you willing to be flexible in your choices of color and sex? *
What do you expect the activity level of this puppy to be?
Do you currently have any other pets? Dogs, cats, and their ages.
Your answer
Any additional information is welcome:
Your answer
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