Contact Information
Name:
Address:
City:
State:
Zip Code:
Home Phone:
Work Phone:
Cell Phone:
Fax:
E-Mail Address:
Puppy Preference
What is your
goal for your rat terrier?
-Select-
family pet / companion
breeding prospect
show prospect
hunting
Do you prefer a male or a female?
-Select-
Male
Female
If
your gender choice is not available, would you
consider the other?
-Select-
Yes
No
What
size rat terrier are you interested in, by adult
weight?
-Select-
Tot-under 5 lbs
Toy 5-10 lbs
Miniature 10-18 lbs
Standard 18+ lbs
What colors do you prefer?
Prior
Rat Terrier History
Have you ever seen a rat terrier in person?
-Select-
Yes
No
Have you ever
raised or owned a rat terrier?
-Select-
Yes
No
What is your
experience with rat terriers?
What characteristics
are you looking for in a rat terrier?
What do you expect
the activity level of this breed to be?
Prior
Dog History
Have you ever raised a
puppy before?
-Select-
Yes
No
What breed/s?
How long did you have the dog/s?
What happened to the dog/s?
Your
Home Environment
What type of home do you
live in?
-Select-
Apt
Condo
Single Family
Mobile Home
Town House
If renting, provide Landlord's
name and phone number
Are there any pet restrictions
where you live?
-Select-
Yes
No
How many hours a day will
the puppy be kept outside?
Describe your outside accommodations
(fenced in yard, courtyard, etc.)
Will anyone be home during
the day, or would someone be able to walk the puppy
during the day?
How much time each day
will your work schedule permit you to spend with
your new puppy?
How do you plan to exercise
your rat terrier?
Describe your indoor accommodations
for a new puppy, and your household training plans.
Your Household
List other adults living in your household.
List children and their ages living in your household.
Is your entire household in agreement with getting a puppy?
-Select-
Yes
No
Other Pets
What other pets live in your household?
Do you have a current vet?
-Select-
Yes
No
If yes, what is your vet's name?
Vet's clinic name:
Vet's address:
Vet's phone number:
Puppy Care
Are you aware of appropriate puppy foods?
Do you have an idea of the costs for puppy shots, heartworm and flea/tick control products?
Can you attend puppy training/obedience classes?
Do you plan
to spay/neuter, or do you intend to breed this
dog?
Your References
Name:
Address:
Phone number:
Name:
Address:
Phone number:
Name:
Address:
Phone number:
About Us
How did you hear about us?
-Select-
Internet Search
Family
Friend
Business Card
Other
Do you have any questions for us?
To the prospective buyer:
Susan H. Cooney Thank you.
