Questionnaire For Prospective Purchasers

I want to ensure that my puppies are matched with the best home for
each of them. Please complete the following questions. There are no
right or wrong answers but please answer all the questions honestly so
that I can best match you with the puppy most suited to your home.
(Please note this form is not designed to be filled out online. Please
copy and paste the text into an e-mail and send it to me at



City:______________________ State:___________



Preferences: I am interested in a male/female Labrador (circle one)

My color preference is black/yellow/chocolate (circle one)

My color/sex preference is very strong/I am somewhat flexible/the color/sex
of the dog are unimportant to me, I just want a healthy, loving pet.
It will be used for: Pet/ Show/ Breeding/ Obedience/ Other (circle one)

Family: Name of Spouse/Companion:
Names and Ages of Children:
Is there anyone else who will be living with the dog?

Pet Ownership Experience: Have you previously owned this breed? YES / NO
Have you previously owned a dog? YES / NO
If yes please provide the following for each dog you have owned (attach list if necessary):

- Breed (or prevalent breed if mixed)
- How obtained (purchased, found, given as a gift, adopted, etc.)
- Age when obtained
- What happened to the dog (sold, given to others, lost, died (include cause of death)
What animals do you currently own?
Do you breed dogs now, or have you had experience breeding dogs?
Which of the following reasons best fit the primary reason(s) you would like to have a dog? If you mark more than one please put a 1 by the most important and a 2 by the next most important, etc.

for spouse
for the children
hunting dog
for other pet
conformation showing
guard dog
obedience showing

What specifically attracted you to this breed? How did you become interested in owning one?
Facilities And Care
Your occupation:
Work Schedule:
Typical hours per week:
Occupation of Spouse/Companion:
Work Schedule:
Typical hours per week:
How many hours per day would the dog be left alone?
Who will be the primary caretaker of the dog?
Do you own your own home?
If not, landlords name and phone number for approval:
The dog would spend most of its time: Outdoors / Inside the Home
The dog's sleeping quarters would be: Outdoors / Inside the Home
Description of outdoor space for dog:
Fenced Yard (give type)
Unfenced Yard
Open Fields
Kennel run
Parks nearby
Walking trails nearby
May I come to see your facilities?
How will your dog be transported?
How will you exercise your dog?

Additional Information: When you travel would you normally travel with the dog? YES / NO
What arrangements would you make for the care of the dog when it is unable to go with you?
Do you need recommendations for boarding facilities?
Is anyone in your family allergic to dogs or dog hair? YES / NO
Please consider what you would do with your dog if any of the following situations were to happen to you:
Divorce * Move * New baby in the home * Loss of job or serious illness
Are you willing to sign a Non-Breeding Agreement? YES / NO

Are you willing to sign a contract authorizing me to seize the dog if you provide me with false information or do not care for it properly, and requiring you to return the dog to me if you are no longer able to care for it properly? YES / NO

Were you referred to me by anybody in particular? YES / NO
If Yes, please list them below: Veterinarian name and phone: (Please contact your vet and ask permission for me to make a reference call.)
Two Personal References - Name, phone, relationship:
Any other comments or conditions to be included in the contract?