~Breeding for the Total Dog...Health, Brains & Beauty...In That Order~
Puppy Screening Questionnaire
Miakoda Kennels, please fill out the following form
in it's entirety. This questionnaire is designed to
help us screen potential buyers, to ensure our puppies
end up in the loving, forever homes they deserve. It
also helps us to determine your needs so that we can
help you choose the best puppy to suit your lifestyle.
Once you have completed the questionnaire, please copy
and paste it into the body of an email and send it to:
Miakoda Kennels
Name:
Age:
Address:
City:
State:
Zip:
Phone:
Email:
Website:
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1. How did you hear about Miakoda Kennels?
2. Have you ever owned an American Pit Bull Terrier/American Staffordshire Terriers, Doberman Pinscher or any other breed of dog? Please list all dogs you've owned and what happened to them.
3. Why did you choose this breed?
4. What are you looking for in a dog?
5. Are you interested in a male or female? Why?
6. Do you have a preference in color? If so, please specify.
7. Are you interested in show or pet quality?
8. If show quality, please specify discipline (Conformation, Obedience, Agility, Schutzhund, etc.) and what your goals are with this dog.
9. Do you have any experience showing and/or training dogs? Please specify.
10. Are you a member of any dog clubs or associations? If so, please list them.
11. Do you have any other pets? What type? How many?
12. Do you plan to breed? Have you have bred dogs before?
13. If so, why are you interested in breeding?
14. Do you have any experience taping/posting cropped ears?
15. Are you willing to wait for a puppy if the right puppy for you is not available right now?
16. Household:
A) Do you have children? How many? Ages?
B) Do you rent or own?
C) If rental, has your landlord approved ownership of an APBT/AmStaff or Doberman Pinscher? Can this be verified? Please supply your landlord's name and contact information.
D) Please specify the type of home you live in (re: House, Condo, Apartment, etc.):
E) Is your home setting Urban, Suburban, or Rural?
17. Housing:
A) How do you plan to house this dog? Inside, Kennel, Outside, Other? (Please explain):
B) Do you have a fenced-in yard?
C) What size is your yard? (length x width)
18. Are there breed specific ordinances in your town? If so, please explain.
19. Are you governed by city, county or state ordinances limiting the number of animals owned?
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Proper animal husbandry and care can require a substantial investment beyond the purchase price. Information requested below is kept in strict confidence and is designed to insure puppy's optimal care.
20. Financial:
A) Are you employed?
B) Average yearly income:
$15,000 - $20,000
$20,001 - $25,000
$25,001 - $30,000
$30,001 - $35,000
$35,001 - $40,000
$40,001 - $45,000
$45,001 - $50,000
$50,001 - $55,000
$55,001 and above
21. References:
A) Please list three (3) personal references, not related to you or living in your household, and their contact information:
1)
2)
3)
22. Please the name and contact information of your veterinarian.
23. Please supply any additional information that might help us find a suitable dog for you. (example: Describe the ideal dog for your needs):
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Thank you!