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Dear Families,
I try to make the best placements for you and my pups. With this in mind, there is some basic information I will need from you before scheduling a visit. Please provide picture I.D. at your visit.

Family Information

Applicant’s Name:
Address:
City, State, Zip:
Home Phone: Other Phone:
Email Address:


Breed of puppy wanted:
Male, Female or either:
Color of puppy wanted:


What expectations/qualities are you looking for in your pup?
Will this pup be for companion, family pet, performance (show/agility/etc.), breeding, therapy, service, etc?

How many people live in hour household?
Ages of children:
Who will be the primary caretaker of the puppy?
How many hours each day will your puppy be alone on his/her own?
What other pets do you currently have?
Have you ever owned/or had contact with a dog that developed parvo? If yes, how long ago?

Do you rent/own? Have you cleared this with your landlord/manger and other members of your household?
What type of set up will you provide for your pup/dog?

Have you selected a Veterinarian yet?
Will you neuter/spay?
Do you plan to breed?
Any other comments you would like to share:

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