Contact Information
Name:
Address:
City:
State:
Zip:
Phone:
Email:
Occupation:
How did you hear about us?
Have you owned a Cavalier before?
Yes
No
Why have you decided to purchase a Cavalier?
Do you prefer a male, female or no preference?
Male
Female
No Preference
If you have a preference, why?
Would you consider “the other sex”?
Yes
No
Do you have a “color” preference (Black/Tan, Blenheim, Ruby or
Tri)?
For what purpose are you acquiring a Cavalier?
Family Pet Obedience Agility Show Breeding Therapy
Do you understand the difference between Limited and Full
registration?
Yes
No
Do all family members want a new puppy?
Yes
No
Would you consider an older dog?
Yes
No
Who will have primary responsibility for the care and feeding of
your new puppy?
Have you ever house trained a puppy before?
Yes
No
How long will puppy be alone?
How long will puppy be outside?
Are there any children living in the household?
Yes
No
What are their ages?
Do any family members have allergies to dogs?
Yes
No
Do you OWN or RENT?
Own
Rent
If you rent, are you aware that many landlords do not permit pets?
Yes
No
House, Townhouse, Duplex, Apartment?
House Townhouse Duplex Apartment
Do you have a fenced yard?
Yes
No
How big is the fenced yard?
Where will your Cavalier sleep at night?
Will this dog be an outside dog or primarily an inside dog?
Outside
Inside
What kind of training i.e. classes or other methods will you
utilize?
Who will train this dog?
Have you ever completed an AKC title of any kind?
Please list:
Do you intend to breed this dog?
Yes
No
Why?
Do you intend to spay/neuter this dog?
Yes
No
What pets do you currently have?
What pets have you previously owned?
Circumstances of your last pet’s death and age?
Have you ever returned a pet to a breeder?
Yes
No
Have you ever given a pet away?
Yes
No
Have you ever taken a pet to pound or shelter? Why?
What do you feed your current pets?
What type of veterinary care do you consider absolutely necessary?
Do you use a heartworm preventative for any currently owned dogs?
Yes
No
What would you do if you found that you could no longer keep this
dog?
If you found, that you could no longer keep this dog, would you be willing to
return it to us?
Yes
No
If no, why not?
How do you feel about dog hair on your rugs and furniture?
What type of personality are you looking for in your puppy?
What do you think will be the best part/parts of having a Cavalier
in your life?
What do you think will be the worst?
What do you and/or your families do for fun?
How active are you? Are you an avid hiker, swimmer, runner,
computer nut, couch potato?
Do you and/or your spouse work outside your home?
Yes
No
If so, how many hours would the puppy/dog be left alone?
What are your plans, as to how to raise the puppy, while working?
How many vacations a year do you take?
Where do you like to go on vacation?
What will you do with your dog while you are away?
Please feel free to add any comments or questions.
Current or Prior Veterinarian for Reference
Name:
Address:
Phone:
Please list any other references you would like for us to contact
Name:
Phone:
Name:
Phone: