Questionnaire | Pixielane

First name

Last name

Email

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Housing Type

Have you read any resource materials on this breed?

Yes

No

Do you have any prior experience with this breed?

Yes

No

Your veterinarian's name, phone number, and address:

Is anyone home during the day?

Yes

No

Where will the puppy be kept during the day?

Where will the puppy be kept during the night?

How many hours on average will the puppy be left alone?

Will there be someone available to feed and exercise the puppy?

Do you have any other animals? If yes, please list breed, age, and sex below.

Do you have children?

Yes

No

Does anyone in your household have any known animal allergies?

Yes

No

Do you have a puppy gender preference?

Male

Female

No Preference

What are your activity level expectations for this breed?

Do you have a fenced in yard or suitable pen?

Yes

No

Do you have any prior experience potty training a puppy?

Yes

No

Do you plan on attending any puppy training classes?

Yes

No

Have you ever had to return a pet to their breeder? If yes, please explain the situation below.

Have you ever given a pet away? If yes, please explain the situation below.

Have you ever surrendered an animal to a shelter or rescue? Is yes, please explain the situation below.

Do you intend to breed the dog?

Yes

No

By checking this box you agree to return the puppy to their original breeder shall the need occur.

Pixielane

Please complete the following questionnaire to be considered for one of our puppies. Thank you.

Please complete the following questionnaire to be considered for one of our puppies.
Thank you.