Puppy Pickup Acknowledgment Form
Please complete this form to confirm and acknowledge the handoff of your puppy. All information will be used solely for the purpose of confirming the pickup.
Your Full Name
*
First Name
Last Name
Your Email Address
*
example@example.com
Your Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Puppy Name
*
Date of Pickup
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Condition of Puppy at Pickup
*
Healthy and in good condition
Minor issues (please explain below)
Other (please explain below)
Comments or Notes
By signing below, I acknowledge that I have received the puppy described above and confirm the pickup.
*
Submit Acknowledgment
Submit Acknowledgment
Should be Empty: