CHARISMA COTON DE TULEAR
(Prospective Puppy Owner Survey)
(Feel free to send this via regular mail or copy & paste into an e-mail)

Your Name: __________________E-mail:__________________

Phone Number:_____________ Fax:_______________

Address:____________________________________________

Profession:___________________________________________

How many dogs have you previously owned:__________

Breed (s):_______________________________________

Why do you no longer have these dogs?________________________

How many dogs do you currently own?____________________

Describe their temperament:______________________________

Gender:_________________ Are they spayed/neutered?__________

How, where & when did you learn about the Coton de Tulear?____________

What are your reasons for wanting a Coton de Tulear?_______________

Where do you live? House_______ Apartment_____ Other__________

Do you have a securely fenced, dog friendly yard?________________

Will your dog be mostly in the yard or other and what percentage of time will your dog be there?____________________________

Are you away from home for many hours a day and where will your dog be during this time?_____________________________________

If you are away for work or vacation, what provisions will you have for it's care?____________________________________

Do you travel often and could you take the dog with you?_______________

Do you plan to use a crate and if so for how long?____________________

Where will your dog sleep at night?___________________________

Are there any behaviors you won't tolerate in your dog?_______________

Is there someone in the family who is willing to brush & groom the dog several times a week, and if not would you use a professional groomer? ____________________________________________________

Would you commit to feeding your dog a high quality dog food (not grocery store dog food)?___________________________

How do you feel about regular Vet checks and vaccines?________________

Do you have any plans for training & socializing your dog, and if so what avenues might you pursue?_________________________________

Do you have children, if so what are their ages?__________________

Any other family or extended family members?__________________

Please explain why you want to bring a new dog into the family at this time and if all the family members are in agreement with this decision?_______________________________________________________

Can you give a personal reference?_________________________

Your Veterinarian or Clinic name, address & phone number_______________

________________________________________________________________

Your groomer's (if you have one) name, address & phone number_________

________________________________________________________________

Describe your personality_________________________________

Do you have any hobbies?____________________________________

Do you prefer male_________ female_____________

Which do you prefer, a white puppy__________ a tri-color puppy________

Will you plan to spay or neuter this dog?__________________________

Filling out this puppy questionnaire will be very helpful to us and aid in placing a suitable puppy for your family and your particular needs. Thank you for taking the time to complete this form.

Signature________________________ Date___________________________

Please copy and send in an email to mtrainier90@myway.com
or print it and fax to 360-825-2564