EmailMe Form - Royal Retrievers Puppy Application

Date *

Owner's Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Main Phone *

### - ### - ####

Secondary Phone

### - ### - ####

Email *

Referred to Royal Retrievers by: *

Puppy Preference *

If for Service, what medical condition:

Veterinarian's Name/Clinic *

Vet's Phone *

### - ### - ####

Have you owned a dog before? Detail: *

How many individuals in your family? Detail: *

Type of Work for Owner(s) (all adults): *

Were the adults in family raised with dogs/pets? Detail: *

Have you as an adult personally owned a dog? Detail: *

Do you have other pets and/or livestock at home? If Cats, declawed? Detail: *

Is everyone in family agreeing on getting a puppy? If not, detail: *

Does anyone in family have allergies? Detail: *

Will someone be home with puppy during the day? Detail: *

If not home daytime, what arrangements do you have mid-day for puppy?

What is the size of your yard? *

Do you have or will you have Fencing? *

How close is your fence line to your neighbor's? *

What kind of pets and/or livestock do your neighbors have? *

Do you plan on spaying/neutering your puppy? If not, why? *

Will your dog be an "inside" dog? If No, where will she/he be kept? *

Do you plan on going to Dog Parks? If so, where? *

Do you plan on going to Dog Day Care? If so, where? *

What kind of training do you plan on doing for your puppy? Where? *

Additional Information IF you currently have a another pet(s) at home. If more than one, please detail in the "Others" box.

If you do not have another pet at home, please skip to the bottom Agreement to Application section.

Name:

Type(s) & Breed(s):

Current Age:

Date Acquired

MM / DD / YYYY

Age at Acquisition

Sex

Male

Female

Fixed?

Yes

No

Vaccinations Current?

Yes

No

List the health history of your pet

ex: health issue 1, health isue 2,...

Is your pet on any medication?

Yes

No

If you have cat(s), are they declawed?

Yes

No

If Yes, what medication and why?

Where did you get your pet?

Pet's diet

Pet's daily routine

Training:

Does your current pet show signs of aggression:

Yes

No

If Yes, Describe

Does your current pet show signs of fear:

Yes

No

If Yes, describe

Where is your current pet kept when you are home

Where is your current pet kept when you are away:

Where is your current pet kept at night:

How would you describe your current pet's personality:

What bad habits does your current pet have:

What commands does your current pet respond to:

Who does your pet play with the MOST?

Adults

Children

Other animals

Him/herself

What does your current pet prefer to do when you are at home:

Follow people around and nicely interact

Follow people around and obnoxiously interact

Be in the same area, but not much interaction

Independent and not follow people around

Interact with other pets

What games does your current pet like to play:

How often does your current pet Come when called:

90% or more

75%

50%

25% or less

List future goals for you and your pet

ex: goal 1, goal 2,...

Detail Other Pets:

AGREEMENT TO APPLICATION:

I agree to an In-Home visit prior to puppy going home. Satisfactory In-Home visit required in order to purchase a puppy from Royal Retrievers. *

I agree

I agree that the above information I have entered is true and accurate. *

I agree

Date *

MM / DD / YYYY

Additional Information IF you currently have a another pet(s) at home. If more than one, please detail in the "Others" box. If you do not have another pet at home, please skip to the bottom Agreement to Application section.

AGREEMENT TO APPLICATION:

Additional Information IF you currently have a another pet(s) at home. If more than one, please detail in the "Others" box.

If you do not have another pet at home, please skip to the bottom Agreement to Application section.