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 In Remembrance of Susan Nelson

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HavSerenity Havanese Questionnaire

The following questions are being asked of you so that the right puppy and

the right placement of each puppy is made by bringing the various

requirements of both the puppy and his or new owner(s) into perspective,

BEFORE a choice is made. Families are not all alike and puppies, even from

the same litter, have different personalities. A dog that would be a

happy and sutable in one home could be a nightmare for another! Your

answers to the questions below will help us understand your situation and the

type of dog that would fit in with your lifestyle.

Please answer the following questions as completely

and as you can, and submit this form when you've finished.We would like to

be as supportive as possible, so you and your family may live a long and very

happy life with your new Havanese family member.

We do everything we can to e-mail or call
back promptly, so please, if you have not heard back from us with in 48hrs after submitting
the form below, feel free to re-submit, e-mail or give us a call as
a problem may have occurred with the submission

 

About You:
 
Your name:
Address:
City/State/zip:
Phone - Home:
Phone - Cell:
Email:
Refered By (web serach, Dog club , person etc):
 
About Your Family and Household
If you have children or if there are children who often visit, please tell us about them (ages, genders, activity level anything else you think might be relevant)
Does anyone in the household have allergies, physical disabilities, or other health problems that might relate to the type of dog that would be suitable?
Yes     No
If so, please give us some idea of what they are.
Who will usually take care of the dog?

occupation of that person? (in general--we don't need details.)

You are aware that Havanese are indoor dogs and should never be left outside unattended for long perids of time?
Yes     No
Comments:
What type home....
House    Apartment    Townhouse    Condo
...and community?
City    Suburbs   Rural    Small town Other

Comments:

How long have you lived here?
Do you rent or own ?
If renting, Does your landlord know you are getting a new puppy? Are pets allowed in your lease aggreement? Upon request may we see that portion of your aggrement and may we contact your landloard? any other details you would like to add:

Do you have a fenced yard or suitable pen? What type of fencing and how tall is it? (block, chain link, invisible etc.)

If you don't have a fenced yard, how will you exercise your Havanese?
About Your Pets
Please tell us about any other pets you have. If dogs, how many, breeds or mixes, ages, whether inside or outside dogs, and whether they are neutered or spayed. If cats, whether they are indoor or outside, and ages.
How many dogs have you owned in the past 10 years?
Would you tell us what happened to them?
Have you ever returned a pet to the breeder? If so, what were the circumstances?
Do you currently have a vet? If so please list the Name, address and phone number of your veterinarian.
 
About Your Havanese
How did you decide on a Havanese as the breed for you?
Have you become acquainted with the Havanese breed on a personal level? If so please explain
Yes     No
Comments:
Are you looking for a puppy or an adult Havanese?
Puppy     Young Adult (1-2 years)  Adult Undecided
What is the prefered time frame to bring your new Havanese home?
Which gender do you prefer (or does it matter?)
Male Female    Doesn't matter
Is there anything else that's especially important to you as far as your future Havanese? (e.g., color preference, personallity traites, specific age, etc)
 
Will someone usually be home with your Havanese during the day?
Yes     No
 
If not, how many hours at a time will he be alone most days?
How many hours total will he usually be alone daily? (For example, if you work, but come home for lunch, he'll be alone four hours at a time, but eight hours total.)
Will there be someone available to feed and exercise the puppy during the day:
Where will your dog stay while you're away?
Crate    At large in house     One room     Yard
Comments:
 
Where will your Havanese sleep?
Will you keep your Havanese primarily indoors or outdoors?
Please check any activities, if any, in which you plan or would like to participate with your Havanese.

Conformation (showing)
Obedience
Therapy dog
Freestle Dancing
Agility

Flyball
Traveling frequentlly with owners
general puppy class training sit down etc.

None just a happy couch potatoe companion.
Other

Comments
If not planning to show your dog, are you willing to spay/neuter her/him?
Yes No
Comments

Should your circumstances change so that you are no longer able to care for this dog, will you agree to check with us before selling him or giving him away?

Yes No

Please add anything about yourself that will help us understand how a Havanese would fit your home and lifestyle. Include amount of time spent at home, amount & range of physical activity, travel, entertaining, "noise level" of household, anything you want to add about your children, other pets, etc.
 
Finally...
This information will be used to help find a Havanese for you. If we don't have a suitable one, is it all right for us to forward your information to other breeders who may be able to help?
Yes     No


If you have any problems submitting this form, eaither print it out and fax it to us or please e-mail us through the contact us page .

We'll get back to you as soon as possible.

Please Fax to:
661-367-9002

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