My Yorkie & Biewer Dreams

Name: ______________________________________ 
Address: ____________________________________________ 
City: ___________________________________ State: ______ Zip: ________________ 
Phone Number: (____) _____-_______

Cell Phone: (____) _____-_______
 EMail:___________________________________________________________

Occupation: _____________________________________________________________ 
Work Hours: _____________________________________________________________  

HOUSING 

Do you live in a: ___House ___Apartment ___Townhouse___ Other___
Do you _____own or ____rent your home?
How long have you lived at this address? ________________________ 
If you rent, do you have the landlord's permission to keep a dog? _____________  

FENCE / YARD / CRATE INFORMATION

Do you have a completely fenced yard suitable for a dog? ___Yes ___No

Describe fence  ______________________________________________________________ 

If no fence how will you handle the dogs exercise and toilet needs? ________________________________________________________________________

Do you have a suitable dog crate? ___Yes ___No

If no, are you willing to purchase one? ___Yes ___No

HOUSEHOLD INFORMATION

How many adults in the home: _______Children: _______ Age and gender of children: 
________________________________________________________________________

Who in the household will have the main responsibility of caring for this pet? ________________________________________________________________________

How many hours & what time of day a will the dog be alone? ________________________________________________________________________
 

OTHER ANIMAL INFORMATION

Do you own other dogs? ___Yes ___No spayed/neutered? ___Yes ___No Please list breed, size, and gender of each: ________________________________________________________________________ ________________________________________________________________________ 

Do you own cats? ___Yes ___No If yes, how many? ___________ 
Other animals in the home? ___Yes ___No if yes, please describe: ________________________________________________________________________ ________________________________________________________________________ 

Have you ever returned a pet to the breeder? ___Yes ___No If so, what were the circumstances? ___________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 

Have you ever given a pet away? ___Yes ___No If so what were the circumstances? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 

Have you ever taken a pet to the pound or shelter? ___Yes ___No If so, what were the circumstances? ___________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 

Have you owned a Yorkie before? ___Yes ___No 

Why did you choose this breed? _______________________________________________________________________________

Will you be attending any training classes? ___Yes ___No           If so, what kind? _______________________________________________________________________________

Do you plan on keeping this dog primarily? ___Indoors ___Outdoors 

Where will dog sleep? ___________________________________________________________

Do you have a regular vet? ___Yes ___No

Name: ____________________________________Phone:______________________________

Address: ________________________________________________________________ 

PUPPY PREFERENCES

SEX: __female __male __no preference/unsure

Have you considered an older dog instead of a puppy? ___Yes ___No ___unsure