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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
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