Puppy Placement Questionnaire

 

Your assistance in completing this questionnaire will help me place the right puppy with you.  If you feel that additional information would be helpful, please attach a supplement to the questionnaire.  All information will be kept confidential.  Thank you for your cooperation and interest.

 

NAME: __________________________________________________     Date: ________________

ADDRESS: ______________________________________________

CITY:   __________________________________ ST: _______  ZIP: __________

HOME PHONE: _____________________________

BUSINESS PHONE: __________________________                    

EMAIL: _____________________________________

How did you first learn about the Vizsla?  Why would you like to own one?

 

 

 

 

 

Do you prefer:    ___ Male   ____ Female     ____ No preference  

 

What is your interest in purchasing this puppy (check all that apply):  ___ Family companion   ___ Conformation (show)           

___ Field Trials   ___ Obedience    ___ Personal Hunting   ___ Breeding   ___ Agility   ___ Flyball  

___ Other _________________________

 

Do you have any pets now? __________  If so, what kind?  ____________________________________________

 

What was the breed of your last dog if you had one? _________________________________________________

If you have previously owned dogs, please tell me something about them, what they were like, where you

got them and, if they are no longer with you, what happened to them?

 

 

 

 

 

What did you like best about them?

 

What did you like least?

 

How many people live in your household? _________       

Do you have children and, if so, what are their ages? ________________________________________________

 

Where will your dog spend most of his time when he is at home with you?                                                                                  

___ Crate   ___ Yard   ___ Free in the family residence   ___ Restricted area of our home   ___ Outside kennel 

___ Other

 

 

Is someone in your household home during the day? _______________

If not, where will your dog be kept while you are out? ________________________________________________

Do you have an outside kennel run or enclosed/fenced yard? ____________If so, approx size: ________________

 

Do any family members have allergies to dogs? ______________________________         

Do all family members want a new puppy? ________________________________

 

What hobbies and activities do you and your family members enjoy and will your dog participate in any of these?

 

 

 

Do you live in a:     ____ House    ____ Condo    ____ Apartment   Other, please specify: ___________________

Do you rent or own your residence? _________________________

If you rent, does your lease allow you to have pets?   ____ Yes     ____ No           

Is there a size or number restriction? ________________________

 

Are you willing to take this dog to socialization and obedience classes so that he will become an enjoyable

companion and canine good citizen? _______________________________________________

 

Who will train this dog?  ________________________________________________________________

 

Have you, or anyone in your family, ever completed an AKC title in:                                                                                           

____ Obedience     ____ Field        ____ Conformation        ____ Tracking         ____ Other

 

Have you achieved canine titles from other organizations such as NAVDHA?  _____________________________

___________________________________________________________________________________________

 

Are you committed to care for this dog and its needs for its lifetime? _________________________________

Have you ever euthanized a dog? _________        If so, why? ___________________________________________

 

What type of personality are you looking for in a dog?

 

 

 

 

 

Are you willing to spay/neuter this dog? ___________________________________

 

If you are purchasing this dog for future breeding, are you willing to obtain the necessary clearances of                                       

OFA, Thyroid, Brucellosis, and any others that may be necessary including DNA registry through AKC?

 ______________________________________________________

 

Are you willing to consult with me, and other knowledgeable people in the breed, before breeding this

dog? __________________________________________________

 

Is there anything you would like me to know that hasn’t been covered in this questionnaire? 

 

 

 

 

 

Do you have any questions you’d like to ask me about the breed and/or about dogs in general?

 

 

 

 

 

Please provide the name, address and phone number of your current veterinarian or the veterinarian you intend to use with your new puppy. 

 

 

Also the names and phone numbers of 2 individuals who know you well and would be willing to act as a personal reference.

 

 

 

 

 

 

Thank you again for completing and returning this questionnaire.

Jazzan Kennels

Please return to:   Leslie Ann Johnson     

    7047 Refugee Rd. SW    Pataskala, OH 43062 

Email:  jazzanvz@msn.com

Phone: 740-964-5139

 

Puppy Packet from Jazzan Vizslas, History, Training and Care (on line)