Name:
Address:
City: State:
Zip:

Home Phone: Cell :  

Email Address:

Occupation:

 1.  How did you find us?
 

2. Do you prefer: MALE or FEMALE? Please explain why:

 3. What color do you prefer? Please Select Cream Apricot Black Chocolate Red 

4. Do you want to reserve a puppy from a specific litter?
Yes No
If yes, which one: 

5. Does everyone in your family want a new puppy?
Yes No

 6. Does anyone in your family suffer with allergies?
Yes No
If yes, how severe?

7. Do you have children?
Yes No
 If Yes, please provide their ages:

 8. Will this be your family’s first dog?
Yes No

9. If no, what is your level of experience with dogs?

10. Do you currently own a dog?
Yes No
Age:   Breed:  

11. Do you have any other pets?
Yes No
What Types: 

12. Do you have a fenced in yard?
Yes No 

13. Will the puppy be home alone all day?
Yes No

 14. If yes, will puppy be taken out for a mid-day break and play time?
Yes No 

15.  Will you continue the crate training we have started?
Yes No 

16. Are you aware of the time and energy needed to care for a young puppy and willing and able to accept that responsibility?
Yes No 

17. Do you have the means to budget the cost of a new puppy?
(Puppy shots, monthly heartworm medication, annual vaccinations, crate, bedding, food, toys, grooming products, etc.)?
Yes No 

18. Are you committed to caring for this puppy for it’s lifetime?
Yes No 

19. Will you be attending an obedience class with your puppy? 
Yes No 

20. Did you attend an obedience class with your previous dog?
Yes No 

21. What is the name of the veterinarian or clinic you will be using for the puppy?
Name:
Phone:  

22. Have you used this vet before?
Yes No 

23. May we contact them for a reference?
Yes No

24. We request that a dog be returned to us, at any point in time,

should you determine you are no longer able to care for the dog.

Are you willing to agree to this?
Yes No

25. Do you agree to spay/neuter your puppy before 7 months of age?
Yes No  (we do not necessarily require this)

NAME AND PHONE NUMBER OF TWO REFERENCES ARE NEEDED

Name:
Phone:   

Name:
Phone: 

You can mail your application with your $200.00(doodles) $100.00 (labs) deposit to:  CHECKS SHOULD BE MADE PAYABLE TO     KATHY MARSHALL

Kathy Marshall 3090 South Road, N. Ft. Myers, Fl. 33917

 I have answered all of the above questions truthfully. I understand that I have answered all questions truthfuly

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