Brussels Griffon prospective puppy owner questionnaire

Name(s)

Address: Street

City

State

ZIP

Country

Email Address: Please enter a single & valid email to which we can reply

Phone number

Please Tell us about your Family/Household: Description Please Tell us about your Family/Household: Description Single Married Unmarried Couple/Roommates

Children: names & ages

Profession(s) & work schedule

Other family in the home: age & relation

Other Pets in the home: species & ages

Current residence information: Type of home Current residence information: Type of home Single family/Detatched Townhouse Apartment or condo Other

What type?

Ownership Ownership Own Rent

Neighborhood Neighborhood City Suburban Rural Farm

With a yard? With a yard? Yes No

Fencing Type? Fencing Type? Chain Link Privacy Split Rail Electronic Other None

What type of fencing?

Describe where you live to include any more details that help paint a full picture of your home.

Past and Present - Pet Specifics: Including your current dogs, what breeds have you owned and what happened to them?

Who would be the primary daily caretaker of the dog, and describe a typical day in their life.

Who is your current or prospective veterinarian?

What are your plans for exercising your dog during inclement weather?

Does your family travel often, would the dog travel with you and/or how the dog be cared for during your absence?

Will your dog primarily live inside or outside of the house? Will your dog primarily live inside or outside of the house? Inside Outside

How many hours will the dog be left alone during the day? How many hours will the dog be left alone during the day? Never Less than 4 hours 4 to 8 hours More than 8 hours

Which of the following activities are you interested in engaging with your dog? (check any/all that apply) Which of the following activities are you interested in engaging with your dog? (check any/all that apply) Dog Shows Agility Obedience Breeding

For the above checked areas of interest, please describe why and history in each.

Do you plan on crate training your puppy? Do you plan on crate training your puppy? Yes No

Do you plan on taking your puppy to obedience/manners/good citizen classes? Do you plan on taking your puppy to obedience/manners/good citizen classes? Yes No

Are you willing to provide us with follow-up reports as needed or requested? Are you willing to provide us with follow-up reports as needed or requested? Yes No

Are you interested in a male / female / either (no preference), and why?

Are you interested in a smooth / rough / either coat (no preference), and why?

Are you interested in a particular color - red / black / black & tan (no preference), and why?

Are you interested in a puppy, teenager or adult and why?

What is your preferred timeframe for getting a puppy and why?

If you could describe the PERFECT dog, traits, behaviors, size, etc... you would want them to be?

Griff Specifics: How and why did you choose a Brussels Griffon over other breeds for this addition to your family?

What is your experience with Griffs and/or other Toy Breeds?

Are you familiar with the grooming requirements for a Griff with a Rough Coat and would you be doing this grooming yourself?

General Information: How did you hear about JOVAL and why did you choose our Kennel?

Elaborate on any special circumstances that you wish to be considered that were not discussed elsewhere on this form.

By Clicking the "Submit Answers" button below, I attest that ALL information entered on this form is true to the best of my knowledge. Further, I certify that I am 18 years old or older and acknowledge that I have researched the Brussels Griffon breed and are ready, willing and financially able to properly and without limitation provide proper living environment, proper health care and adequate training. JOVAL Kennels reserves the right not to sell a puppy to anyone and for ANY reason. (This includes but is not limited to our wish to retain the puppy for our breeding program, or we have found a home that we feel is more suitable for a specific puppy, or we have new information regarding your application.) PLEASE PLACE HERE THE ELECTRONIC SIGNATURE OF PERSON COMPLETING THIS FORM - THANK YOU