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? Yes
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? My mother is home all day.
If not, where will your dog be kept while you are out?
Do you 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? Own
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? No
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.
___________________-
The above is what I had to fill out to get my Vizla.