First Name:
Last Name:
City & State:
E-mail address:
Phone number:
1.) Why have you decided to purchase a Great Dane?
2.) What breed(s) of dog have you owned in the past?
3.) Do you currently have any other pets? Yes No
If yes, what types, ages and temperament?
Are they spayed or neutered? Yes No
4.) Have you ever purchased a dog and then later sent it
Yes No
If yes, why?
5.) Have you ever had to put a pet down (euthanize)? Yes No
If yes, please explain the reason:
6.) Do you currently have a veterinarian that you use? Yes No
If you would like to offer your vet as a reference, please
Please describe your family and home...
7.) Number and ages of any children in your (If there are no children, do you have regular visitors who
8.) Are all the members of your family in complete
Not
Yes No
If "no" or "not sure", please explain:
9.) Do any members of your family have any known
Yes No Not
10.) Which best describes the area where you live?
Urban Suburban Rural
11.) Do you live in a: single family house, duplex, condo,
> Do you: Rent Own
If you rent, have you checked with your landlord (and/or
Yes No
12.) Do you have a completely fenced in yard? Yes No
If yes, what type of fencing and how high is it?
If no, where will your puppy be allowed to eliminate and
13.) Is a member of the family home throughout the day?
Yes No
If no, how many hours per day will the puppy/dog be left alone?
Where would the puppy/dog be housed during the day if/when
Please describe what you are looking for in a Great Dane puppy...
14.) Why are you interested in purchasing a Great Dane? (You may select more than one)
Companion (family pet) Showing
Obedience (competition) Breeding
Therapy dog If you selected "showing", do you Yes
No
15.) Do you have a gender preference?
Male Female No preference
16.) Do you have a color preference?
Yes - please specify: No preference
17.) If your preferred color or sex is unavailable in the litter Yes No
18.) Have you done your research and are you familiar with:
-The general care requirements of a Great Dane (both puppy and Yes No
-The potential health issues associated with Great Danes? Yes No
-The amount of attention, patience, training and love that is Yes No
19.) Are you willing to spend the time to properly socialize Yes No
20.) Are you aware of the costs involved in properly raising Yes No
> Any additional information that you would like to
Thank you for taking the time to complete this form. "Reset" will clear all fields.
