Barhund CSP. . .
Puppy Questionnaire
Name____________________________________________________
Street Address:________________________________________
City:
___________________ Providence/State:____________
Postal Code/ Zip:______________
Home Phone: ( ) _________________ Work Phone: ( ) ___________________
E Mail address:
___________________________________
Name of Co-Applicant_____________________________________
Relationship: Spouse ( ) Parent ( )
Child ( ) Other ( )
1) How did you hear about our Chinese Shar-Pei?
2) What do you know about the breed (temperament,
health, etc.)?
3) Do you have a preference in coat, color, sex or
age?
4) Do you rent or own your own home:
5) What type of home do you live in?
Apartment ( ) House ( )
Duplex ( ) Mobile Home ( ) Condo
( ) Other ( )
6) If you rent, please provide us with the property owner’s name and phone
number.
(*Please note that we will contact your
property owner)
7) How long have you lived at this address?
8) Are there any covenants (restrictions, size, number, type) that prevent you
from having a particular pet? If yes, please
explain.
9) Who will be responsible for the care of this dog?
10) If you have children living in your home or that visit on a regular basis,
please indicate their ages.
11) How many hours will your dog be alone per day?
12) Who will care for this dog while you are on vacation?
13) If you have to move what will you do with your
dog?
14) Are you willing to take responsibility for this dog for the next 10 or more
years?
15) The name and contact information of your veterinarian(s) *We will call them for
a
reference.
16) Have you ever owned a Chinese
17) If you have owned animals in the past, what happened to those
animals?
18) If you have other animals, please fill out the sections below.
Breed/Type
___________ Age________ Spayed or Neutered
Breed/Type____________Age________
Spayed or Neutered
Breed/Type____________Age________
Spayed or Neutered
19) Do you have a fenced yard and what kind of fencing do you have?
20) If you do not have a fenced in yard, how will your
22) Where do you plan to keep your
23) Where will your dog sleep at night?
24) What will you do with your dog when there is no one at home?
Signature
_____________________________________________ Date: ____________________
Signature
_____________________________________________ Date: ____________________
Please send
completed questionnaire to:
BARHUND CHINESE SHARPEI
C/O
43 Sycamore Street