| Your Name |
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| Address |
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| Home Phone Number |
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| Work Phone Number |
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| Email Address |
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| Web Page |
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| Referred By |
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| What reference materials have you read? |
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| How many individuals of this breed are your acquainted with? |
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| Type of Dwelling |
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| How long at this address? |
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| If Renting, Please provide the name and address of your landlord |
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| Name, Address, and phone number of your veterinarian |
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| Why would you like a Doberman Pinscher? |
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| Are you interested in a male or female puppy? |
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| What do you expect the activity level of this breed to be? |
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| Have you ever owned a dog before? |
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| Do you currently own any other dogs or cats? What kind and what sex? |
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| How long did you last pet live? What were the circumstances of its death? |
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| Have you ever given a pet away? If so, what were the circumstances? |
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| Have you ever returned a dog to the breeder? If so, what were the circumstances |
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| Do you have any children? If yes, what are their ages? |
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| How many people reside in your household? What are their ages and sex? |
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| Does anyone in the household have allergies to pets? If so, to what and how severe? |
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| Who will be the primary care giver? |
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| Where will the puppy be kept during the day? |
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| Where will the puppy be kept during the night? |
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| Is anyone home during the day? |
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| How many hours on average will the puppy be left alone? |
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| Will there be someone available to feed and excercise the puppy |
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| What kind of floor surfaces will the dog be on in the house? |
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| How many hours will the puppy be kept outside? |
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| Do you have a fenced yard or suitable pen? |
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| Have you ever house trained a dog before? |
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| Do you have any experience with cropped ears? Taping ears? |
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| Will you be attending any training classes? |
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| Are you interested in showing the dog in the conformation ring? |
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| Have you ever shown a dog to its Championship? |
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| Are you interested in competing in performance events such as Agility, Obedience, Schutzhund, etc.? |
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| Have you shown a dog to any performance titles? |
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| Are you interested in breeding the dog? |
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| Are you a member of any dog clubs? Please list |
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| What would your goals be with your Bell'Lavoro Puppy? |
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| Describe the IDEAL dog for your needs. |
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