Liz Hallsworth 5425 Forest Falls Dr.
PROSPECTIVE PUPPY OWNER QUESTIONNAIRE
Address: Street______________________________________________ City_____________________State_____________Zip_______
Daytime Phone Number:
Evening Phone Number:
TELL US ABOUT YOU:
1. How many members does your family have and what are their ages?
2. What are their occupations? Their hours of work?
3. Are there likely to be any major changes in your lifestyle in the near future? (such as moving, pregnancy, care of an elderly relative, etc.) If so, please describe.
4. Is there someone in your family who does not want a pug or who dislikes dogs?
5. Is anyone in your family allergic to animals? If so, what kind of animal?
6. When is the best time to reach you by phone?
Tell us why you want a pug? TELL US ABOUT YOUR RESIDENCE:
1. Is your residence rural, suburban, or in the city?
2. How long have you lived at your present address?
3. Do you have a pool? If yes, is it fenced in?
4. Do you have a fenced yard?
5. Does your home have air conditioning?
6. Do you own your current home?
7. Are your renting your current home?
If yes, will your landlord allow pets?
TELL US ABOUT YOUR PETS AND YOUR EXPERIENCE WITH ANIMALS:
1. What kind of pets do you currently own?
2. Do you own a cat(s)? If so, how many?
3. If so, are they declawed?
4. List the types and ages of dogs currently in your household.
Are your dogs spayed/neutered? If not, please state reason.
6. List the name, address and phone number of your veterinarian.
7. Have you ever owned a Pug before?
8. If yes, from whom did you obtain him/her?
9. What happened to this Pug? If deceased how did he/she die?
10. Have you ever owned any other breeds of dogs? If yes, please list types and state what happened to them or if deceased, how did they die.
11. Have you ever attended conformation (show) classes with your dogs?
12. Have you ever attended obedience training with your dogs?
13. Will you enroll in conformation or obedience classes with your Pug?
14. Are you willing to train your new dog?
TELL US ABOUT THE PUG YOU WISH TO PURCHASE:
1. What color pug are you looking for, fawn or black?
2. What age?
3. Male or female?
4. Would you accept a Pug of the opposite gender if your first choice was not available?
5. Where will the Pug live?
6. Who will be the primary caregiver to the Pug?
7. How long will the Pug be left unattended during the day?
8. Where will your new Pug sleep?
9. Do you plan to use a crate for your Pug?
10. Are you willing to return the Pug to the breeder should some unforeseen circumstance arise and you were no longer able to keep the Pug?
11. Are you willing to administer daily eye drops to the Pug if he/she needs it?
12. Are you willing to have the Pug’s anal glands expressed if he/she needs it?
13. Are you willing to have the Pug’s nails trimmed on a regular (weekly) basis?
14. Are you willing to accept full financial responsibility for all veterinary care and costs for the Pug once you have purchased the Pug?
Is this Pug for someone else? If yes, who and why?
TELL US MORE:
1. Do you have any additional requirements?
2. Is there anything else you think we should know about you, your current pets, your family, home, etc?