Breugel Bouviers Perm. Reg'd. Puppy Questionnaire

| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Thank you for your interest in a Breugel’s Bouvier des Flandres Puppy.   I use my puppy questionnaire to ensure that all my puppies go to the best homes possible, be it a show, companion or foster home. Please help me by filling in this securely encrypted confidential questionnaire that will only be used for the purposes of placing a puppy into its new home.   This questionnaire may seem involved but as a potential owner you should be pleased that I place my puppies very carefully.
Contact Information
Please enter your first and last name.
Please enter your email address. We can not respond unless it is entered.
Please provide your street address.
Please enter the city or town where you live.
Please enter the province or state that you live in.
Please enter your 10 digit phone number.
Best time to contact you?
Referral
How did you find us?
Puppy/Dog
Are you interested in?
What gender do you prefer?
What coat color do you prefer?
Do you prefer natural or cropped ears?
What are your plans for your Bouvier?
What activities are you interested in pursuing?
Why are you interested in a Breugel's Bouvier?
Have you read Pam Green's article Don't buy a Bouvier?
Are you willing to spay/neuter your dog?
Are you willing to take your dog to obedience classes?
Where will your dog stay during the day?
Where will your dog stay at night?
Where will your dog stay when left alone?
How much time will you spend with your dog each day?
How much time will your dog be left alone each day?
How will your dog be exercised?
How will your dog be socialized?
Are you aware of the exercise, grooming and tranining requirements for Bouviers?
Are you committed to caring for this dog for its lifetime?
Your Pets Past and Present
Have you owned a Bouvier before?
Have you owned dog(s) previously?
Where did you get your dogs from? Select all that apply.
Do you currently have other pets?
Have you ever surrendered an animal to a rescue or shelter?
Have you ever had to euthanize a dog?
Have you ever returned a dog to a breeder?
Family Environment
Are you Married or Single?
The Adult age(s) living in the home?
Do you have children living at home?
Who in the home will be responsible for the dogs care?
Are all family members in agreement about acquiring a Bouvier?
Anyone at home allergic to dogs?
Anyone living at home smoke?
Where do you live?
Do you live in a house or apartment/condo?
Do you rent or own your home?
Do you have a fenced yard?
References
Do you currently have a vet?
Please provide two personal references.
Additional Information