Forms

QUESTIONNAIRE

Please complete and return the following questionnaire. This will assist us in the selection of an appropriate puppy for you and your family.

Name:                                                                                                                           

Address:                                                                                                                                 

City:                                                                   State:                                                             

Zip:                                E-Mail:                                                                                                 

Phone:                                                   FAX:                                                                            

How many people are in your household?                                                                              

Do you have children?     Y / N

If yes, what are their ages?                                                                                                   

Does every family member want a dog?                                                                                 

If not, please explain:                                                                                                 

Who will be responsible for caring for the dog and what is their general home/work schedule?

What made you decide to get a dog, and particularly, a Chinese Shar Pei or a Portuguese Water Dog?                                                                                                                                                                                                                                                                                                                                                                                                                               ______

For what purpose are you purchasing a CSP or PWD? (Check all that apply to you)
Family pet                      Obedience Training                              Show Breeding                     
Therapy Dog                  Agility                                                   Water work                           
Other                                                                                                                                      

Do you have experience in raising and training a puppy?

Do you currently have dogs in your household?               Y / N

If yes, please explain:                                                                                                            

Do you have them professionally groomed, or do you groom them yourself?                                                                                                                                                                        

Do you have any special concerns about CSPs or PWDs?                                                                                                                                                                                                                   _____________________________________________________________________

What facilities do you have for your dog?                                                                                                                                                                                                                               

Is your yard fenced?                                                                                                               

What is the approximate size of your yard? _________________________________________

Where will you keep the puppy?     Inside / Outside

Do you own a crate? ________________ Size                                                                      

Do you understand the financial commitment involved in having a pet, other than the original cost of the dog? (Veterinarian cost, quality food, regular grooming)                                                                                                                                                                 ____________

Are you willing to spay/neuter this dog? (if no state why please)                                                                                                                                                                                                                               _________________________________________________________

Are you interested in a puppy or a young adult?     Puppy             Young adult                     

Do you want a male or a female?     Male             Female             No Preference       

Would you prefer a PWD wavy or curly coat?     Wavy           Curly          No Preference        

Would you prefer a CSP horse or brush coat?     Horse_____  Brush______ No Preference____

What coat color do you prefer?___________________________________________________

You would like a puppy/adult as of what date?                                   ____________