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PLEASE make SURE that ALL Questions marked with an * ARE completed otherwise you can NOT submit this Questionnaire !

1. All current dogs in the home MUST be spayed or neutered. (proof required) Exceptions MIGHT be made for medical reasons.

2. All Dogs in the home MUST be current on annual vaccinations and monthly heart worm and flea prevention. (proof required)

3. We require a home visit prior to adoption.

4. All our adopted Dogs have to be INDOOR pets.

Pet of Interest*

First Name and Last Name*

Your age*

Profession

Marital Status*

Email Address*

Phone*

City*

Zip*

Address*

State*

Are you a Student?*

Who else lives in your household besides spouse, children?*

How many adults (18 +) are in your household*

How many children (18 - ) are in your household?*

Ages of children in your household!

Is anybody in your household allergic to pets?*

Do you Rent or Own?*

If Rent - pls enter Landlords name and contact Info

Is your property fenced in?*

Type of fencing*

Other - Explain

Height of Fence?*

What is your experience with owning a dog?*

Current exsisting Pets? Sex? Age? *

Did you lose any pets lately?*

If YES - How did you lose your previous Pet (s)

Have you owned a Puppy the last 7 months? *

If YES Do you still have the puppy?*

If NO what happened?

Current Pets Altered? (spayed/neutered)*

IF NO Why NOT? Explain

You want a dog because (check all that apply)*

Other - Explain

Adopted Pet has to be good with: *

Other - Explain

Where will pet be kept when you are Home?*

Other - Explain

Where will pet be kept when you are NOT Home?*

Other - Explain

When away on vacation do you *

Other - Explain

Name and contact info of current Vet*

What kind of food (Brand) do you feed?*

How many hours will pet be left alone daily?*

How many hours will pet left alone OUTSIDE*

Explain Why would pet be left alone OUTSIDE*

How will Pet be exercised?*

What gender would you prefer?*

What size would you prefer?*

Temperament*

Energy Level*

Where will the dog sleep ? *

If inquiring for one of our Great Danes - WHY are you interested in a Great Dane? *

Is your house and property set up for a XL breed? Please explain *

Have you owned a Great Dane before ?*

Are you financial capable to take proper care of a Great Dane/XL breed? Danes require high value food and vet bills are in direct proportion to their size ! *

I ATTEST THAT ALL ANSWERS I HAVE PROVIDED ON THIS QUESTIONNAIRE ARE CORRECT*

Type applicants name to serve as Signature*

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