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New Puppy Form

As a breeder of the German Shepherds, it is our responsibility to make sure that a puppy that we have bred, which will have my name listed on the puppy’s registration papers, be placed in the most appropriate environment, as such, we would ask you to complete the following questionnaire to give us a better idea of your family, your lifestyle, and how a puppy will fit into it. Our breeding program is centered around the betterment of this versatile breed and the promotion of responsible dog ownership. Purchasing a puppy is not something that should be done on a whim but should involve much research and planning. Be prepared to assume the financial responsibility of care for a puppy including inoculation, vet care, good quality food, and licensing, etc. Please complete the questionnaire with as much detail as you can. Any questions left unanswered will not automatically disqualify, but will hinder my responsibility as a breeder to match the best puppy to your situation. Though some of the questions may be considered highly personal, please be aware this questionnaire is highly confidential and that no one but Vom Issam Haus kennels will see the results of the questionnaire. If you wish to send an email with your answers you may send your email to: [email protected]
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Telephone (evening & daytime):*
Email*
Date
MM slash DD slash YYYY
Number of adults living in house*
Number of children under 18 living in the house*
If you have children, what has been their experience with dogs?*
What is your current employment status?
Do you foresee any changes in the next 5 – 10 years?*
Are you interested in a male or female puppy? Why?*
Would you consider the opposite sex if it is a better match for your family or we are unable to provide the preferred sex?
- Yes
- No
What do you expect the activity level of the German Shepherd to be:
- Very high
- High
- Moderate
- Below average
Who will be the primary care giver?
How did you learn about Vom Issam Haus?
Does anyone in your family have allergies?
- Yes
- No
Describe your personality and your family’s:*
Have you ever owned a dog?*
- Yes
- No
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If so, what breed(s)?
Do you still have the dog(s)?*
- Yes
- No
Hidden
If yes how will he/she/them adjust to a new puppy)
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If not, why
Have you ever had to euthanize a dog? If so, why:*
Have you ever had to take a dog to a shelter or pound: If so, why:*
Have you ever returned a pet to the breeder? If so, what were the circumstances?*
What circumstances, in your mind, justify getting rid of a dog?*
Where did you get your previous or current dog(s)? Check all that apply:*
- Breeder
- Pet Store
- Breed Rescue
- Shelter
- Stray
- Gift
- Other
Do you have any other pets? If so, what kind?*
If you have other animals, how are they going to adjust to the new addition
Do you currently have a veterinarian? If so, what is the name/clinic/telephone number, and may I contact them for a reference?*
How did you decide that you wanted a German Shepherd?*
Do all family members want a German Shepherd?
- Yes
- No
What is your interest (mark all that apply):*
- Show/Conformation
- Performance/ Obedience/ Agility/ Rally
- Breeding
- Pet/ Companion
- Other (specify)
Have you ever raised a puppy? If so, what breed? Who was the primary caretaker of the puppy?*
With regard to grooming, please complete the following: I think German Shepherds’ require:*
- Daily Brushing
- Weekly Brushing
- Grooming (bathing and drying) more than every 6 months
- Grooming 2X per year
- Don’t know
Do you like to brush a dog?*
- Yes
- No
Previous dog training (if applicable):
- I personally trained my dog
- A personal trainer trained my dog
- I took my puppy to puppy kindergarten
- I took my puppy beyond puppy kindergarten
- I train for obedience trials
- Conformation
- Agility
- Other
- I don’t believe in dog training
How do you plan to contain your puppy while it is outside:*
- Kennel run (existing)
- Kennel run (will build)
- Hidden fence
- Tether, chain or rope
- Fenced yard
- On leash only
- No restraint – run loose
Will there be someone available to feed and exercise the puppy during the day?*
How many hours per day on average would your dog be left alone?*
Where will the puppy sleep at night?*
When you are on vacation, who will take care of the puppy?*
When the puppy is travelling in the car, how will it be contained?*
Do you have a pool?*
- Yes, we have a pool and it is fenced
- Not fenced
- We don’t have a pool
Complete the following: I am looking mainly for an:*
- Inside dog
- Outside dog
- Both
If you are purchasing a pet/companion dog, will you agree to sign a contract stating that the dog will not be used for breeding purposes?*
- Yes
- No
Details about your family’s residence(s):*
- City/house
- City/ apartment
- Suburb/ house
- Suburb/ apartment
- Country house (less than 1 acre)
- Country house (more than 1 and less than 3 acres)
- Country house (more than 3 acres)
- Condo
- Cottage
- Other
Are you planning on moving in the near future?*
- Yes
- No
Do you foresee any change in your lifestyle in the next 5 years (birth, retirement …)?*
- Yes
- No
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If yes please describe:
Do you enjoy going for walks: How long and how often?
Describe a typical weekday:
Please tell me a little bit about what you are looking for in a German Shepherd, and what type of activities you would likely be pursuing (coach potato, jogging companion, a buddy for the kids, etc.):

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