Chaos Creek Questionnaire

Name:
Email Address:
Phone
Address: (INCLUDE City & State)
Occupation:
Name & Age of Household members:
Who will be responsible for the dogs care:
Is someone home during the day:	Yes No
If no how is this handled:
Do all family members want a dog:	Yes No
Are any members of the household allergic to dogs:	Yes No
Do you	Own Rent
	Apartment Townhome House
Yard size and Fencing Type:
Have you ever owned a dog? When? What happened:
What pets do you presently own:
Have you ever met a Rottweiler	Yes I have one Yes No
When/How did you become acquainted with Rottweilers
Do you understand Rottweilers are a guardian breed:	Yes No Tell me More
What makes you think this is the right breed for you
Dog will be housed:	Indoors Outdoors
Do you plan on crate training:	Yes No Tell Me More
Who will take care of the dog when you are gone for extended periods or vacations:
How will the dog be confined in your absence:
Veterinarian’s name, Address, Phone:
Your puppy will require housetraining, socialization, training classes, daily exercise and weekly grooming. It will be much like having a new baby in the way it disrupts your life. Do you understand the time, energy & commitment required to get a puppy through its first year?	Yes No
What will you do to get through this:
Will you allow for a home inspection by either Chaos Creek or one of its friends prior to the sale of the puppy:	Yes, In person or virtual Yes, Virtual No Thanks
In placing dogs with buyers, I consider this agreement a pact between parties to secure the dog’s welfare for its lifetime. In this agreement, I offer lifetime refuge for any dog I produce which buyer cannot keep. Will you promise to return the dog to me should some unforeseen circumstance prevent you from keeping the dog any longer with little or no monetary refund?	Yes No
Puppy Prefrences
I am interested in	Puppy Adult Either
Preferred Gender	Male Female Either, the right temperament is most important
Do you intend to Spay/Neuter	Yes Yes but after they turn 2 No, I want to breed No, I just dont want to spay/neuter
What are you looking to do with your dog:	conformation guard dog agility companion obedience therapy tracking breeding other
If other please specify
Initial here to verify this questionnaire is filled out truthfully and you understand Chaos Creek will review all questionnaires and there will be a contract for all puppy sales.