Puppy Questionnaire

Kristle and David Marangon

26628 Woodland Way S

Kent WA 98030

Cell: (253) 632-4305

marinellapwds@comcast.net

QUESTIONNAIRE

Please complete and return the following questionnaire. This will assist us in the selection of an appropriate puppy for you and your family.

Full Name

First Name Last Name

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Phone Number

Area Code Phone Number

E-mail

How many people in your household?

Do you have children?

If yes, what re their ages?

Does every family member want a dog?

Yes No

If not, please expain:

Have you or do you own a Portuguese Water Dog?

Yes No

If you have, Please list your breeders?

What made you decide to get a dog, and particularly, a Portuguese Water Dog?

For what purpose are you purchasing a PWD? (Check all that apply to you)

Family Pet Obedience training Showing / Potential Breeding Therapy Dog Agility Water Work Boating Other

How would you describe your lifestyle?

Active Mocerately Active Inactive

Please list Employer / Occupation for all applicants

If not employed please explain your ability financially to meet the needs or the PWD

Who will be responsible for caring for the dog and what is their general home / work schedule?

What experience or interaction have you had with a PWD? If none we can try to get you a meet and greet

Will your PWD be left alone during the day?

Yes No

If yes for how long?

Where will your PWD spend his time when alone?

Are you willing to crate train your puppy?

Yes No

Do you own a crate?

Yes No

If yes, size and type

Do you have experience in raising a puppy?

Yes No

Do you currently have dogs or cats in your household?

Yes No

If yes, please list

If you do not have a dog now, have you had them in the past?

Yes No

If yes, what breeds?

Do you have or will you have them professionaly groomed or do you groom them yourself?

Type of residence

Do you have a yard?

Yes No

Is it fenced?

Yes No

What is the approximate size of your yard?

If you do not have a fenced yard, what are your plans for exercising your PWD?

Do you understand that any PWD placed in your care is not to be tied up outside or allowed to run loose outside a fenced area - including dog parks?

Yes No

Where will you keep the PWD?

Inside Outside Combination

Do you understand the financial commitment involved in having a pet, other than the original cost of the dog? (such as Veterinarian cost, quality food, regular grooming and appropriate and safe facilities?

Yes No

Do you understand the time and commitment involved in having a dog... Such as feeding, general care, grooming, training, playing, exercising and himan companionship?

Yes No

Would you be willing to take your PWD through obedience training?

Yes No

Are you aware of the following health problems in the breed?

Cardiomyopathy Addison's Disease Hip Dysplasia Progressive Retinal Atrophy

Are you willing to spay / neuter this dog at the age specified in the purchase agreement?

Yes No

Are you interested in a puppy or a young adult?

Puppy Young Adult

Do you want a Male or Female

Male Female No Preference

Would you prefer a wavy or curly coat?

Wavy Curly

Coat color preference

Black Brown Black & White No Preference

You would like your new puppy as of what date?

In the interest of making better breeding decisions for the future of the PWD, it is important for breeders to obtain health information about all PWDs as they mature.

Would you be willing to health test a dog placed with you in accordance to the guidelines set forth by the Portuguese Water Dog Club of America?

Yes No

Please provide additional informaion that you think might be helpful:

Please Provide the names, addresses and phone numbers for 2 references.

By filling out this questionnaire and submitting it, you understand that this does not in any way guarentee you a puppy from Marinella Portuguese Water Dogs. It is only the first step in the interview process.