Refleksion Kennel, reg. - Puppy Questionnaire

Once you have completed the questionnaire, please email me at refleksiongsps@aol.com to let me know it was filled out and I
will let you know if I have received it. Also, please leave a contact name and phone number in your email.

Thank You!

Please read our kennel policies here

Please answer questions to the best of your ability

Do not fill in this field

Name

Address

City

State

Zip Code

Email

Phone

Cell phone (optional)

Best time to call

Day
Evenings

Are you a breeder?

Yes
No

Have you ever owned a dog before?

Yes
No

If yes, how many and for how long? If they are no longer with you, please explain why?

Have you had experience with this breed?

Do you have children?

Yes
No

If yes, what ages?

0-5
12 or older
5-12

What personality traits do you look for in a dog?

Do you prefer a male or a female?

Female
Male
No preference

If you have a preference, why?

How many hours a day will your puppy be alone?

Where will he be kept when alone?

Where will your puppy sleep at night?

Are you aware of the financial costs of having a dog?

Yes
No

Would you be interested in joining a breed club?

Yes
No

If a puppy is sold as a companion/pet, would you accept limited (Non-Breeding) registration?

Yes
No

If no, please explain why

Do all family members want a new puppy?

Yes
No

Do you have a color preference?

Yes
No

Do you own or rent?

Please check one

Apartment
Condo
Duplex
House

Do you have a secure yard?

Yes
No

If yes, please describe. How big?

Please describe type of fencing

Where will your puppy be when you are home?

If other, please explain

Have you read Our Policies?

Yes
No

Are you willing to take your new puppy to obedience or beginning puppy school?

Yes
No

If this is a Show puppy, are you willing to sign a Show Contract?

Yes
No

If No, please explain

If this is a companion/pet puppy, are you willing to sign a Spay/Neuter Contract?

Yes
No

If no, please explain.

How did you hear about us?

Additional questions or comments

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