If you are interested in a puppy please copy and paste this questionnaire and e-mail it to rjharrin@ymail.com
Law Enforcement, Vendors and those in that industry parts of this questionnaire will not pertain to you,
please contact me directly with your name, department or business name, and what sort of dog you are looking for.
Law Enforcement, Vendors and those in that industry parts of this questionnaire will not pertain to you,
please contact me directly with your name, department or business name, and what sort of dog you are looking for.
Puppy Questionnaire
DISCLAIMERS
You understand that any dog of any breed and level of training can bite and should not be left un-supervised with children ever.
You understand that even with training this dog may not get along with other dogs or pets in the household.
If you rent and the landlord will not allow you to keep the dog, you agree you will not sell or rehome the dog, it must be returned to the breeder and no refund will be issued.
If you can no longer keep the dog or no longer want the dog, for any reason, you agree to give the breeder first right of refusal before
re-homing or selling the dog.
Sign:__________________________________________________ Date:________________________
TELL ME ABOUT YOU:
Name:
Address:
Primary Phone:
E-mail address:
If you are married, is your spouse on board with adding a dog?
Do you rent or own your home?
Do you have children living with you or visiting regularly? If yes, please note ages.
How many dogs do you currently own?
Age, breed, sex, spayed/neutered?
What happened to your prior dogs? past away, re-homed, sold?
What will you do with the dog if you go on vacation or have an emergency?
What will happen to the dog if you move?
WHAT I AM LOOKING FOR:
Please list all dog sport clubs or organizations you are a member of:
If none please list why you want a Malinois and what activities you plan to participate in:
Please list any titles, awards, or certifications you have earned and on what breeds:
What will happen to this dog if it doesn't meet your training goals?
Do you understand that a fenced yard is not adequate for exercising this dog?
WHAT YOU WANT:
I will assume anyone wanting an intact dog plans to breed.
Breeding rights are given once a dog has passing OFA or PennHIP hip and elbow ratings at 2 years of age
and passes at minimum an IGP BH or similar temperament test or certification.
Male or Female?
Intact, Vasectomy, or Spayed?
Companion dog or sport / performance/ working dog?
Temperament you are looking for in a dog? i.e. pushy, confident, off-switch, high food drive, high prey drive etc...
VETERINARIAN INFORMATION / REFERENCES
If you have a veterinarian, please provide contact information below
Clinic Name/Name of vet
Clinic Address
Phone
E-mail
Please supply two references (veterinarian, dog trainers, club members, friends, etc. - not immediate family) who know you well enough to recommend you.
Name
Address
Phone
E-mail
Relationship to you
Name
Address
Phone
E-mail
Relationship to you
By signing this questionnaire, I affirm that all statements made above are true to the best of my knowledge.
Name____________________________________________________________ Date ______________________________
You understand that any dog of any breed and level of training can bite and should not be left un-supervised with children ever.
You understand that even with training this dog may not get along with other dogs or pets in the household.
If you rent and the landlord will not allow you to keep the dog, you agree you will not sell or rehome the dog, it must be returned to the breeder and no refund will be issued.
If you can no longer keep the dog or no longer want the dog, for any reason, you agree to give the breeder first right of refusal before
re-homing or selling the dog.
Sign:__________________________________________________ Date:________________________
TELL ME ABOUT YOU:
Name:
Address:
Primary Phone:
E-mail address:
If you are married, is your spouse on board with adding a dog?
Do you rent or own your home?
Do you have children living with you or visiting regularly? If yes, please note ages.
How many dogs do you currently own?
Age, breed, sex, spayed/neutered?
What happened to your prior dogs? past away, re-homed, sold?
What will you do with the dog if you go on vacation or have an emergency?
What will happen to the dog if you move?
WHAT I AM LOOKING FOR:
Please list all dog sport clubs or organizations you are a member of:
If none please list why you want a Malinois and what activities you plan to participate in:
Please list any titles, awards, or certifications you have earned and on what breeds:
What will happen to this dog if it doesn't meet your training goals?
Do you understand that a fenced yard is not adequate for exercising this dog?
WHAT YOU WANT:
I will assume anyone wanting an intact dog plans to breed.
Breeding rights are given once a dog has passing OFA or PennHIP hip and elbow ratings at 2 years of age
and passes at minimum an IGP BH or similar temperament test or certification.
Male or Female?
Intact, Vasectomy, or Spayed?
Companion dog or sport / performance/ working dog?
Temperament you are looking for in a dog? i.e. pushy, confident, off-switch, high food drive, high prey drive etc...
VETERINARIAN INFORMATION / REFERENCES
If you have a veterinarian, please provide contact information below
Clinic Name/Name of vet
Clinic Address
Phone
Please supply two references (veterinarian, dog trainers, club members, friends, etc. - not immediate family) who know you well enough to recommend you.
Name
Address
Phone
Relationship to you
Name
Address
Phone
Relationship to you
By signing this questionnaire, I affirm that all statements made above are true to the best of my knowledge.
Name____________________________________________________________ Date ______________________________