Name* First Last Email* Phone*Why do you want a puppy?* Companion for Another Pet Companion for Self Protection Gift Surprise Gift Watchdog Replacement Pet To Breed To Sell To HuntHow many people live in the household?*The number of people by age/category who live in the householdAdults (19 to 65)Seniors (Over 65)Adolescents (12 to 18)Children (3 to 12)Infants (Under 3) Is anyone in the household expecting a baby?* Yes NoExpected due date?How would you rate your general knowledge of puppies?* Very knowledgeable Somewhat knowledgeable Little to no knowledgeWhat have you have done to prepare for your puppy so far?*Are there any other pets in the household now?* Yes NoPlease provide the other pet information:Type of Pet (dog, cat, other)Sex (M, F)AgeSpayed/NueteredWhere Pet Stays (inside, outside, both) Complete a line for each pet.Have you owned any pets before? Yes NoIf any pets died in the last 12 months, what where the circumstances?* Old Age Accident Illness Disease Disease DiseaseName and address of veterinary clinic you plan to use for your new puppy.*Where will the new puppy spend most of his/her time?* Inside Outside Inside & Outside Don’t Know At Work With Me Doggie DaycareWhere will the new puppy stay when no one is home?* Inside Outside Don’t KnowDescribe the pet's outside environment.*Type of shelter, fenced yard, etc.On average, how many hours a day will the puppy be left alone?* 0-3 hours 4-8 hours Over 8 hoursWhat age group will have primary responsibility for housebreaking the puppy?* Adult (19 and older) Adolescent (12 to 18) Child (Under 12) Not ApplicableYour type of residence.* Single Family Duplex Apartment Condominium Townhouse Mobile Home Rooming House DormitoryHow will you train your puppy?* Puppy group class Private lessons We are not training the puppy I don’t know yetWhat will you do with the puppy when you go on vacation?* Take it with us It will stay with a family member Boarding at a facility Pet sitter Private luxury boarding
