Date:

Name:

Address:

City, State and Zip:

Phone:

Email:

(Be sure to type carefully)

In what type of housing do you live?
House in City House in Country Condo Townhouse Apartment Other

Do you own or rent?
Own Rent

If renting, have you received permission from your landlord to have a dog?
Yes No Not Renting
(We will need to have proof in writing, signed by your landlord)

Are you interested in a "Pet Only" or a Show/Breed puppy?
Pet Only Show/Breed

What is your pattern preference?
Solid Dapple Piebald Brindle

What is your color preference?

For Help Picking a Pattern and Color Preference - Click Here

Which coat type do you prefer?
Short Hair Long Hair

Which gender do you prefer?
Male Female

Will shipping be required?
Yes No

Have you ever owned a dog?
Yes No

If yes, please provide details including what happened to any dogs you no longer own:

Do you have any other pets at home?
Yes No

If yes, please describe:

Do you have any children?
Yes No

If yes, please list their ages:

Does anyone in the home or immediate family have allergies to dogs?
Yes No

Do all family members agree with the purchase of a puppy?
Yes No

Have you ever owned a Dachshund?
Yes No

If so, please share your experiences:

If you have never owned a Dachshund, please list any research and experiences you have with this breed:

How did you come to the decision that you would like to own a Dachshund and that this is the ideal breed for you?

Do you have any knowledge or experience with training and caring for a new puppy?
Yes No

Please explain:

Are you aware that with the proper care, love, health and nutrition your new family member could be with you for up to 18 years?
Yes No

Have you ever taken an animal to the animal shelter?
Yes No

If yes, please explain the circumstances:

Do you have a fenced yard?
Yes No

How much time will the puppy spend alone each day?
Less than 2 hours Less than 4 hours Less than 6 hours Less than 8 hours More than 8 hours

Please explain:

Where will the puppy spend most of its time during the day?

Where will the puppy spend most of its time during the night?

Do you plan to crate train the puppy?
Yes No

Who will bear most of the responsibility for the care and training of this puppy?

Are you financially able to care for this new puppy throughout its entire life, including timely veterinary visits?
Yes No

What is the name, address and phone number of the Certified Veterinarian you will be taking the puppy to?

Are you willing to give us follow-up reports on your Dachshund?
Yes No

How would you handle the situation if your new puppy wakes you up 5 times between the hours of 1:00 a.m. and 5:30 a.m.?

How would you handle the situation if your new puppy makes a big mess or stain on your expensive new white carpet?

How would you handle the situation if your new puppy happens to get a hold of a pair of your favorite shoes and destroys them?

When are you planning to adopt a puppy?
Now Future