Puppy Questionnaire
Name
First Name
Last Name
Email
example@example.com
Where do you live?
Street Address
City
State / Province
Postal / Zip Code
Phone number (optional)
Format: (000) 000-0000.
Date
-
Month
-
Day
Year
Date
What type of home do you reside?
Single Family Home
Condominium/Townhome
Apartment
Modular/Trailer
Other
Do you...
Own
Rent
Live with Family/Friends
Other
What type of yard enclosure does your home provide?
4 foot chainlink
6 foot chainlink
4 foot privacy
6 foot privacy
Not fenced
Other
Do you have any children who will live with the puppy?
Do you have other pets?
Yes
No
Please give an information about your pets
On average how many hours per day will your puppy be left alone?
Where will your puppy be kept while you are away from the home?
Does everyone in the home agree to a new puppy?
What do you want in a puppy?
Companion
Breeding
Show Prospect
Field Trials
Other
Do you agree to have the puppy spayed or neutered? If "no" please explain in the "other " box.
Yes
Other
Gender Preference
Female only
Female, but will consider a male
Male only
Male, but will consider a female
No preference
What is your timeline to bring home a puppy?
Now
1-3 months
3-6 months
In the next year
Other
Do you plan on taking any training classes with your new puppy? If yes, please share which classes you are interested in.
Puppy classes
Obedience
Canine Good Citizen
Agility
Field Trials
Conformation
Rally
Other
Is there anything else you feel I should know about you while considering this questionnaire?
Submit
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