First Name:
Last Name:
City / State:
E-mail address:
Phone number:
When is the best time to reach you?
What breed(s) of dog(s) have you owned in the past?
Yes
Do you currently have any other pets?
No
If yes, what types, ages and temperament?
Are they spayed or neutered? Yes
No
Have you ever purchased a dog and then later sent it back to the
Yes
No
If yes, why?
Have you ever had to put a pet down (euthanize)? Yes
No
If yes, please explain the reason:
Do you have a veterinarian? Yes
No
If yes, may we contact your vet as a reference?
Yes
No
Please describe your family and home...
Number and ages of children in your household? (If no children, do you have regular visitors who are (or bring)
Yes
Are all the members of your family in agreement / committed to getting
No
Not sure
If "no" or "not sure", please explain:
Do any members of your family have any types of allergies to dogs?
Yes
No
Not sure
Which best describes the area where you live? Urban
Suburban
Rural
Do you live in a (single family house, condo, apartment, etc.)?
Do you: Rent Own
If you rent, have you checked with your landlord (and/or association)
Yes
No
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
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
Please describe what you are looking for in a Great Dane puppy...
Why are you interested in purchasing a Great Dane? (You may select more than one) Companion
Showing
Breeding
Obedience
Pet Therapy
Other
If your answer is "showing", have you shown a dog before? Yes
No
If your answer is "other", please describe:
Are you interested in a male or female Great Dane?
Male
Female
No preference
Which color / markings are you interested in? Harlequin
Mantle
Merle
Black
Other mis-mark
No preference
Are you familiar with:
-The general care requirements of a Great Dane? Y N
-The potential health issues associated with Great Danes? Y N
-The nutritional requirements of both puppy and adult Great Danes? Y N
-The exercise requirements of both puppy and adult Great Danes? Y N
-The grooming requirements of a Great Dane? Y N
-The amount of attention, patience, training and love that is Y N
What qualities do you like about Great Danes? (Why have you decided to get a Great Dane?)
Any additional information that you would like to
Thank you for taking the time to complete this form.
