Jambolou Doberman Puppy Questionnaire

1.) CONTACT INFORMATION:

First and Last Name: ____________________________________

Address: __________________________________________________________

Home Phone: ___________________________ Work Phone: ____________________________

Cell Phone: _________________________________

E-mail: ______________________________________________________________________

Occupation: __________________________________________________________

Best Place & Time to Call: Home _________________ Work_________________

2.) HOUSING INFORMATION:

1. Do you own or rent your home? _______
2. Do you live in a:

1. House____
2. Apartment_____
3. Townhouse /Condo_____
4. Other (specify) _________

1. Are you renting-to-own? _____
2. Planning to buy within next year? _____
3. Have a home under contract? _____
4. Do you have the landlord's written permission to keep a dog? _____
5. Does landlord have property insurance that will cover a Doberman? _____
   1. RE: landlord permission and property insurance – Can you provide written documentation that indicates both? _____

3.) FENCE/YARD/CRATE INFORMATION:

1. Do you have a completely fenced back or front yard suitable for a dog? _____
2. Do you have a kennel run or invisible fencing? ______
3. Do you have a suitable dog crate for potty training? _______
   1. If no, are you willing to purchase one? _______

4.) HOUSEHOLD INFORMATION:

1. How many adults in the household? _____ Children? _____
2. Age and gender of those in household: ________________________________________________________________________________________________________________
   (having children does not disqualify you from getting a puppy)

1. If you have kids, have they been taught to respect a dog? _______
2. Are any members of your household allergic to animals? _______
3. Who in the household will have the main responsibility of caring for this pet? _______________________________________________________________________
4. If you work Full or part time, will you have the time to take care of the dog? _______________________________________________________________________
5. Are you Active____ or Retired Military____? What Branch? _________________________
6. If you are Active Military
   1. Do you live on base, military housing, rent, or own home?___________________
   2. Are you expecting a deployment soon? _____ If so, who will take care of the puppy while you are away? ____________________________

5.) OTHER ANIMAL INFORMATION:

1. Do you own other dogs? Spayed/Neutered? _____________________
2. Please list breed, size, and gender of each: _______________________________________
3. Do you own any cats? _____If yes, how many? _______
4. Any other animals? If yes, please describe: _____________________________________
   1. (having other pets does not disqualify you from getting a puppy)
5. How many dogs have you owned in the past five years? ______
6. If you do not still own the dog(s), please describe what happened to it/them. Please be specific: _____________________________________________________________________
7. Have you ever returned a pet to the breeder? _________ If so, what were the circumstances? _____________________________________________________________________
8. Have you ever given a pet away? _____ If so what were the circumstances? _____________________________________________________________________
9. Have you ever taken a pet to the pound or shelter? ______ If so what were the circumstances? _____________________________________________________________________

6.) ADULT DOG ADOPTIONS:

(If this section does not apply to you, do not fill out.)

Are you looking for an adult dog? Y / N

Our retired female adoption fees vary, depending on age, health status, health testing that has been done (which is beneficial to a new owner in regards to veterinary care), whether they are already spayed or not, etc. Adoption fees range from $150 plus spay requirement up to $500 for a younger female. Initial read. ____

All of our adults to be placed have been cropped, are house-trained, crate and /or kennel trained, will walk on a leash (may pull some), and are used to being allowed in a fenced area to potty. MOST will not pee or poop on a leash and require a fenced yard. Because some are so agile and can scale fences, we do require forever homes to either have a 5- or 6-foot fence. Initial read. ___

Note: We rarely place our males, as they are utilized longer for stud services, compared to females who have a smaller span of time where they can whelp litters.

7.) DOBERMAN PUPPY INFORMATION:

• Have you owned this type of breed in the past? ________
• Why did you choose this breed? _____________________________________________
• _____________________________________________________________________
• What activities, if any, do you plan on doing with this dog? Check all those that apply.
• ___ Pet ___ Show ___ Guard ___ Hunting ___ Obedience ___ Agility ___ Trials
• Will you be attending any obedience training classes? __________________________
• Where will this puppy be kept? ___________________________________________
• Where will this dog sleep? _______________________________________________
• Will this dog be tied up? _______
• Are you willing to take the time to keep this dog socialized, and well adjusted? ______
• Will your Home Owners Insurance policy cover Dobermans? ______Please call and find out. (State Farm does)

1. Important question…Have you considered the “What if…” possibility of becoming unemployed, disabled, pregnant, homeless, etc? YES /NO What would happen to your pets? ________________________________________________________________________________________________________________________________________________
2. Do you understand that if you are unable to keep one of my puppies, that it must be returned to me and not transferred to any other owner? _____ No matter how old or the circumstance(s)
3. Do you have a problem with having a dog altered (spayed or neutered) ? Yes____ No____
4. Pediatric spay and neutering is not healthy for a larger breed dog. Recommended age for spay/neuter with a Doberman is 18-24 months. Are you willing to abide by these guidelines?
   ____Yes ____No

Note: Natural eared puppies are currently priced at $2,150.00, which includes tail docking, dew claw procedure, 1st shots, weekly wormings, and 2 year health guarantee. This price is for a puppy with natural ears.

If a customer wants their puppy cropped and avoid extra expenses, I will gladly refer to the vet in Delaware or NJ and arrangements with the vet will need to be made by customer. I will not take care of the cropping maintenance once a puppy leaves, on puppies referred out for cropping. Initial read ______

Further information on deposit policies are on our reservation form. (Available online to read or can be emailed to you once this questionnaire has been looked over)

8.) VETERINARY REFERENCE: Please contact your vet and give permission to speak with me about your history

Do you have a regular vet? ______ Is the vet familiar with the Doberman breed? ______

Name: _________________________________________

Address: _________________________________________________________

Phone:_____________________________

9.) PUPPY PREFERENCES:

Gender wanted:                                                     Coat Color:

Female _____                                                                  Red ____

Male _____                                                                       Black ____             No Preference _____

No Preference _____                                                   Fawn ____

                                                                                         Blue ____

Please indicate here 1st, 2nd, and possibly 3rd preferences if applicable _____________________________________________________________________________

Note: I cannot guarantee the gender or color that customers may want. It may take passing on a litter and waiting until the next, if you are firm on a specific color or gender. Customers really need to be flexible, as I cannot guarantee gender or colors in a litter.

9.) MISCELLANEOUS

How did you hear about our kennel? ______________________________

May we text you photos of puppies to your cell phone? ____

If so, which number(s) should we use? ______________________________________

Annual breeding: We breed 2-4 times a year, depending on litters sizes we have. If we have small litters, we may breed additionally and routinely take reservations. There can sometimes be a long wait time for a puppy, often 6 months to 1 year. If you are flexible in gender or color at the time of your deposit, you have a better chance of getting a puppy sooner. If you are firm on gender/color/ or both, we appreciate your patience and will do our best in providing a puppy as soon as we can. Unfortunately, we are normally at the mercy of Mother Nature. Initial read ____

Reservations: Upon my review of your completed questionnaire, I will let you know if I have any questions or concerns. Please understand that I do my best to keep my customers updated on upcoming heat cycles, breedings, due dates, go home dates, etc. I certainly appreciate patience in regards to puppies becoming available, especially should you decide to place a reservation with me.

BUT…I am going to be blunt here… If you intend to continue to look for a puppy that would be available sooner through another breeder, please refrain from placing a reservation with me. It is not fair to other customers who really want to work with ME specifically as their breeder and to be on our reservation list.

I limit reservations in order to prevent disappointment if a puppy is not available. I understand the mentality of those who want a puppy NOW. We all want… what we want, when we want it, right? Of course. Initial read. _____

EVERYTHING ELSE!!! This is the place where you can tell me everything else you would like to. The more the better! (you may add an additional page if you like) ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Please complete this questionnaire and return via email.

[email protected]