Name:_________________________________________   

Phone #: ________________

Address: ___________________________________________

               ___________________________________________

 

Type Interested In (Coat/Sex/Color): ______________________________________

 

1. Have you ever owned a dachshund? ______

 

2. Extent of Experience with a dachshund or toddler. (If currently own, or one that just passed, go to question 6)

 

__________________________________________________________

 

3. Why a dachshund?

 

___________________________________________________________

 

4. How did you pick the coat type you want?

 

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

5. Did you own your dachshund as a puppy, or did you buy the dog when it was older? (for feeding, training, etc purposes) _______________________________

 

6. If female, do you intend to breed the dog? _______

 

7. Do you own any other dogs? What kind? ____________________________________

 

8. Do you have small children? What are their ages? _____________________________

 

9. What are your work shifts, or will someone be staying home with puppy?

__________________________________________

 

10. Please provide two personal references (full name and phone number) that have known you at least 3 years. Preferably, one family member and one associate.

 

1) ______________________________________________________________

 

2) ______________________________________________________________

  
If you are buying a female with the intentions of breeding, please complete the following questions.  

1. Are you familiar with brucellosis, how it is contracted, and its affects?  __  Yes  __ No

 

2. How would you rate your breeding experience?

 

__ 1. No experience

 

__ 2. Watched/Assisted with some deliveries

 

__ 3. Some experience (5 or less deliveries by yourself)

 

__4. Experienced breeder (5 or more deliveries by yourself)

 

3. If you answered 1to Question 2, do you have an associate/family member that has at least some experience and will be able to be with you during your first few deliveries.

      

NOTE: This prescreening questionnaire must be completed within 7 days of a deposit being paid. If a potential buyer is determined to be unfit for purchase, a full refund of money paid will be provided.  The sales agreement and final payment must be completed at least 1 week prior to puppy pick up.