Physical Address: 
Home Phone: 
Work Phone: 
Cell Phone: 
E-mail address:  

 Why do you want a dog?

Are you acquiring a dog for yourself or for someone else?
             If for someone else, are they aware of your intentions, or is the dog to be a surprise?

If you are married, how does your spouse feel about the addition of a Doberman Pinscher?

Do you have children living with you or visiting regularly? 
             If yes, please note gender and ages.

             How do they feel about the addition of a Doberman Pinscher?

             Are you prepared to teach any resident or visiting children the proper way to conduct themselves around dogs?

Who in your family will be primarily responsible for:
             daily care of the dog
             clean up
             vet and food bills

How would you describe your household activity level? 
             Very quiet
             Rather easygoing
             Usually something going on
             Lots of activity

How did you learn about Doberman Pinscher? 
             Why do you want a Doberman Pinscher?

Have you considered other breeds? 
             If yes, what breed(s) and why?

For each dog you currently own, please list the following:
             Name – Breed – Sex – Age – Is pet spayed or neutered?

For each dog you have owned in the past 10 years, please list the following:
             Name – Breed – Sex – Age – Was pet spayed or neutered? – Why do you no longer own the animal? 
             (If deceased, please give age at death and cause of death.)

Do you have other pets? 
             If yes, please list.

Have you or anyone in your household ever been charged with animal cruelty or had any animal taken away from you or any member of your household for suspicion of animal cruelty?
             If yes, please explain.


Is this a spur of the moment decision to own a Doberman? 

Do you live in:
             mobile home
             other (describe)

In which type of area is your home located?

Are there any dog restrictions or laws in your area? 
Have you checked into local ordinances in your area pertaining to owning/housing an animal (e.g., leash laws, required vaccinations, dog licenses, etc.)? 
Are you willing to comply?

Do you own your home or are you renting? 
NOTE:  If you rent, a signed letter from your landlord stating that dogs are permitted on his/her property must be received before a puppy will be placed with you.  The Breeder reserves the right to contact the landlord before placing any puppy. 

             Please provide your landlord’s contact information:

Where will the dog spend most of its time? 
             Where will the dog be when you are away? 
             How long each day will the dog be alone?  
             Where will the dog be when you are at home?  
             Where will the dog sleep?

Have you ever used a crate in housetraining a puppy or dog? 
             Do you intend to use a crate for this dog?

What will you do with the dog when you go on a vacation trip?

Do you have a fenced yard?
             If yes, size of yard, type and height of fencing.
             If no, please explain what arrangements you will provide for housebreaking and for safe and adequate exercise.

If you were to move, change jobs, separate from spouse, what would happen to your dog?

Does anyone in the household have a mental illness including depression, PTSD, or anxiety?