Adoption QUESTIONNAIRE Web Site Name * Address * City * State Phone Number * How much do you know about the Havanese breed ? * Do you know which puppy you are interested in? * Do you know anyone with a Havanese? * Yes No Can you tell us a little about yourself and your family? * Do you have children? * Yes No If so, how old are they? Do you work outisde of the Home? * Yes No How many hours a day would the puppy be left unattended? * Type of Home * House Condo Apartment Do you have a fenced in backyard, that a small puppy/dog could not escape from ? * Yes No If not, have you given any thought about how you would contain the puppy, so he could play & exercise? * Do you have or have you ever had a puppy/dog before ? * Yes No What is or was the breed age of the dog/dogs? Do you have a dog now? * Yes No Was this dog under the care of a veterinarian for *vaccinations, * testing and preventions ? * Yes No Was this dog ever bred? * Yes No Was the dog neutered/ spayed? * Yes No Will this puppy be under the care of a veterinarian for all vaccinations and & preventives ? * Yes No Will this puppy be spayed/neutered at the appropriate age of 6 months? * Yes No Do you have a preferred Veterinary Clinic? * Yes No Name & Phone of veterinary clinic * May we contact your Vet? * Yes No Are you in a stable position to financially, & physically, be able to take care of this puppy, giving it the love, time, attention, and training that it will need & want in order to be a Happy Healthy Havanese ? * Yes No Your Email * Share this:Twitter
