Please complete every question so we can have a clear understanding of your lifestyle and the right Pug for you.
Date:
NOTE: If you don't put "na" in those unanswered question
Contact Information
Your name: Address:
Email: Web Site:
Occupation: Years in Profession:
Phone: Best Time to call:
Your Preferences
Please tell us what kind of Pug you'd like to find, check all that apply:
Living Conditions
How long have you lived at the present address?: Do you rent or own?:
Do you live in a house, condo,
If rent, Landlords Phone:
Are you planning a move in the next 10 years?: If so, what will happen to your Pug?:
Pet Ownership History
Please list all the pets you have owned in the last five years. Tell us their species (Dog/Cat/Bird), breed (Pug/Siberian Husky/Etc.), sex
Have you ever brought one of your pets to a shelter?: If so, why?:
Your Family
Number of adults living in the home?: Number of children living in home?: Ages of children:
Do all family members favor getting a Pug?: If no, what is the situation?:
Does anyone in the household have a known allergy problem?: If so, how will you deal with it?:
Who in the household will be the primary caregiver for the Pug?:
How Will Your Pug Live
Where will your Pug sleep at night?: How will your Pug be confined?:
Will your Pug be in a crate in the car?: If no, how will your Pug be restrained?:
Number of hours per day your Pug will be left home along?: Where will the Pug be when left alone?:
How will your Pug be cared for when you're on vacation?:
Do you have air conditioning in your home?: Does your car have air conditioning?:
If no to either of these, how will you keep your Pug cool in hot weather?:
If so, is it secured from a nosey Pug?:
Do you have a pool or hot tub?:
Do you have a fenced yard?:
Please describe your fence. How high? What kind of
Pugs/dogs are frequently stolen right out of people's yards. How will you ensure that this will not happen?
Will you place identification on your Pug?: Will you be taking your Pug on regular walks or to the park for exercise?:
Will you use a leash to walk your Pug?:
Are you willing to take responsibility for this Pug for the rest of its life?:
If, for any reason, you are not able to care for the Pug at any point in its llife, are you willing to return it to us?
YES NO
Your Knowledge, Experience & Expectations
What equipment & supplies do you plan to have for your Pug?:
How much do you expect to spend to provide vet care annually for your Pug?:
Describe your potty training method & how you will prevent bad behaviors?:
How will you introduce your Pug to the rest of the family to ease the adjustment?:
What types of training or Pug books have you read?:
Do you plan to take your Pug to Obedience classes?:
What kind of behavior do you expect from your Pug?:
How/When did you first learn about the Pug breed?:
Are you willing to send me copies of your Pug's vet reports
Are you willing to contact me with any questions
Please check the boxes of any/all expectations you have for your new Pug. These include, but are not limited to: (Please check all that apply) CONFORMATION OBEDIENCE AGILITY THERAPY DOG WATCHDOG COMPANY FOR OTHER PET FAMILY PET
Please tell me in your own words why you'd like to get a Pug, and why you're interested in one of our Pugs.
Please provide me with the name, address and phone number for your veterinarian:
Please provide me with the name, address and phone numbers of two personal references:
Name of current employer, Supervisor's name & phone number:
Are you a current or past member of any Pug and/or dog clubs, any offices held, and any performance or conformation experience:
If I don't have an available Pug for you, or one that would fit into your family, do
Check this Box to agree:
Questions, comments, or feedback:
