Puppy Buyer's Survey

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

What is the best time to call you? *

What is your occupation? *

Name *

Relationship *

Phone Number *

Do you own or rent your home? *

Own Rent

Who carries your homeowner's or renter's insurance? (Be sure to check with your carrier - some insurance companies exclude certain breeds of dogs.) *

If you rent, do you have the property owner's permission to keep a dog? *

Yes No

Name *

First

Last

Phone Number *

Do you live in a *

House Apartment Trailer Other (please describe)

How long have you lived at this address? *

If less than one year, please give previous address *

Line 1

Line 2

City

State

Zip Code

Country

Do you have a fenced yard? *

Yes No

If yes, please list height and type of fence *

Does fencing completely enclose the yard for the dog? *

Yes No

If there is no fence, how will you handle the dog's exercise and toilet duties? *

Do you have a separate kennel run? *

Yes No

If yes, please list height and size *

How many hours, on average, will the dog spend alone? *

How many adults in the household? *

How many children? *

Age(s) and sex of children *

Are there regular visitors to your home, human or animal, with which your new dog must get along? Please describe. *

Do you own other dogs? *

None 1 2 or more

Are other dogs spayed or neutered? *

Please list breed(s), age(s) and sex of any other dogs *

Do you own cats? *

None 1 2 or more

Do you own any other animals? *

How many dogs have you owned in the past five years? *

Please explain the circumstances if you no longer have these dogs: *

Do you have a regular veterinarian? *

Yes No

Name *

First

Last

Phone Number *

Name of veterinary practice *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Have you owned a Doberman before? *

Yes No

Why did you choose the Doberman? *

Do you plan to attend Puppy Kindergarten/Puppy Socialization classes? *

Yes No Maybe

Do you plan to participate in obedience classes? *

Yes No Maybe

Please describe your lifestyle (stay at home, hiking, biking, evening activities, etc.) *

Please provide any other comments you feel would be helpful matching the right puppy with you. *

San Fernando Valley Doberman Pinscher Club

San Fernando Valley Doberman Pinscher Club

Please fill in all fields and submit.