Name *
Address
Phone Number *
Business Phone Number
Fax Number
Email *
Please provide the name and description of the pet(s) you are interested. *
Please list your age and the ages of children in your household. *
Please list the names and type of pets currently in your household.
Are your current pets spayed/neutered?
Yes
No
Are your pets current on all vaccinations?
Yes
No
Please list the names of past pets and what happened to them. *
Do you own or rent your home? *
Own
Rent
Please check the type of home you reside.
Single Family Home
Multi Family Home
Apartment/Condo
If you currently rent please provide the name and telephone number for your landlord so that we may
Do you have a yard? *
Yes
No
Is your yard fenced on all sides?
Yes
No
What is the height of the fence?
Where will your pet be kept when you are at home? *
Where will your pet sleep at night? *
How will you provide for your pet's *
How many hours a day will your pet be left alone? *
Are you prepared to housebreak this dog? If so, what method will you use? *
What obedience training if any, will you provide this dog? *
What is your estimate of the annual cost of food, supplies, routine veterinary, and emergency care *
We require a reference from your current veterinarian and grooming salon. Please provide their contact information including name, address, and telephone. As a courtesy you may wish to let them know we will be calling. *
Thank you for your time....
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