Today's Date


Name


Address




Evening Telephone Number


Email

Please list the people in the family.
Include names and ages.



Have you or a member of your family
or someone living in the home been
convicted of or suspected of animal
abuse or neglect?




Is there any time of day that the puppy
will be alone? Please describe where
the puppy will be when no one is home
and length of time it will be alone.




Please describe any pets you have at
your home. If you have additional
dogs, please state if they are spayed
or neutered.


Please describe your fenced yard.





Where will the puppy stay during the
day and sleep at night?
Please describe.



Are you willing to obedience train your
puppy?

Can I or a local breeder visit your
home?

Have you read the sample contract?




Do you have any questions about the
contract you would like to discuss
further?







What type of activities do you enjoy
doing with your dogs?





Please list your veterinarian's
name,address and phone number and
alert them that I will be calling the
veterinarian for a reference.
(permission to release information)


What gender puppy do you desire?
(Please select one choice. I do not
guarantee gender of puppies)




Please write any additional comments
that would help me to select a puppy
for your family's lifestyle. Puppies are
"Puppy Tested" at 7 weeks of age and
matches made according to lifestyle.

Please also list any desires in quality
of  puppy like markings, size,etc.
I have a Bernese litter planned for
August, 2017.  Would you be
interested in being considered as a
"forever family" for this litter?
I have a Cardigan litter planned for
August, 2017.  Would you be
interested in being considered as a
"forever family" for this litter?
I make every attempt to place my puppies in loving and caring homes and this
questionnaire will assist me in getting to know you and your family better.  
Thank you for completing this questionnaire.