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First Name
Last Name
Street Address
City
State
Zip Code
Phone
Email
Puppy name or number
Veterinarian name and number
Are you of legal age at least 18 years old, to purchase a puppy?
*
Yes
No
Do you live in a house/apartment/condo that allows pets?
*
Yes
No
N/A
If you rent/lease is it acceptable to have a puppy where you live?
*
Yes
No
N/A
Do all the adults living in the homeapprove of this purchase? Such as a spouse etc.
*
Yes
No
N/A
Do you have other dogs/cats currently?
*
Yes
No
If yes please list
If yes are they spayed or neutered
*
Yes
No
Should you have to move to another location, will you be able to relocate with the puppy?
*
Yes
No
Have you ever been convited of animal abuse or cruelty?
*
Yes
No
Do you understand and agree this is a pet only puppy? No registration papers will be provided.
*
Yes
No
Do you understand this puppy's vet, grooming, feeding, and housing needs?
*
Yes
No
You understand that we don't accept checks, and if you pay with a credit or debit card there is a 3% fee for doing so?
*
Yes
No
You understand and agree that your down payment is nonrefundable?
*
Yes
No
Have you read, understand, and accept terms and conditions of our warranty?
*
Yes
No
Please state the purpose and use of a puppy purchased from us?
Please sign and date
Thank you! We’ll be in touch.
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