Puppy Questionnaire
Your Full Name
Your Home Stree Address
City, State, Zip
Your E-mail Address
Your Home Phone
Your Work Phone
Your Cell Phone
What are you looking for?
A Doberman Pinscher
A English Cocker
Reason for wanting a Puppy?
Have you ever owned a Doberman/English cocker before?
Yes
No
What are you looking for in your new puppy?
Show/Conformation
Pet/Companion
Service/Working
Other
What color puppy are you looking for? (Check All that apply)
Black/Rust (Doberman)
Red/Rust (Doberman)
Blue/Rust (Doberman)
Fawn/Rust (Doberman)
Red/Orange in Parti Colors (E.Cocker)
ROAN PATTERN (E.Cocker)
TICKING PATTERN (E.Cocker)
OPEN MARKED PATTERN (E.Cocker)
TAN MARKINGS (E.Cocker)
Doesn't Matter
List Your current pet(s). (Age, Sex and if spayed/neutered)
Time Frame looking for a new puppy?
Family members & ages.
How much time will the puppy be alone?
Is your yard fenced?
Yes
No
Other
Height & Type of existing fence?
If no fence: will you provide one before your puppy comes home?
Yes
No [No fence, no puppy]
Other
Current or prior Veterinarian:
Your Vet's Address.
Your Vet's Phone Number.
First Reference: Name, Address and Phone Number.
Second Reference: Name, Address and Phone Number.
Anything else you would like to tell us about yourself?
How did you hear about us?
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