Puppy Questionnaire Avida Portuguese Water Dogs

Avida PWDs

Elaine & Chris Rasmussen

510-583-0170 (voice)

847-556-0170 (fax)

Castro Valley, CA 94552

Thank you for taking the time to complete this questionnaire. Your answers will allow us to match one of our puppies to your lifestyle and requirements. This is very important to us, and Avida PWDs reserves the right to refuse to provide a puppy to any applicant for any reason. You must fill out a questionnaire completely to be considered for one of our PWD Puppies. You will receive an acknowledgment of receipt of this form via email.


*ABOUT YOU*
Your First & Last Name:
Occupation:
Company:
Address:
Address (cont):
City:
County:
State / Province:
Country:
Zip / Postal Code:
Home Phone:
Work Phone:
Cell Phone:
Email:	e.g., you@aol.com
Do you own your home?	own rent
Do you have a fenced yard?	yes no
If yes, please describe fence (type, height):
Your Age:
ABOUT YOUR FAMILY
Marital Status:
If Married/Long Term Relationship, please indicate: Spouse/Partner's Name
Spouse/Partner's Occupation:
Company:
Does your spouse/partner know and approve of owning a PWD?
Children?	yes no
If yes, what is/are their names and ages?
Other pets? If yes, please give the names and describe type, breed, sex, and age of each:
Are your pets spayed/neutered? Please specify which one(s):
Do you have a veterinarian? His/her name and address please:
If you have had a dog before, describe the dog you owned and what happened to him/her?
Why are you interested in owning a PWD?
Have you owned a PWD before? If yes, what did you enjoy most about him/her?
Where will the dog stay during the day?
At night?
How many hours per day will the puppy be left alone?
Have you ever returned a pet to a breeder?	yes no
Have you ever given a pet away?	yes no
Have you ever taken a pet to a shelter or pound?	yes no
If any of the previous answers were yes, please explain the circumstances:
*Your Preferences*
I am most interested in a:	male female either
I prefer this hair type:	curly wavy either
I prefer color/markings:	black brown with white any coloration
Are you interested in showing in conformation, agility or water competitions? Please explain:
Are you interested in:	young puppy only older pup(4 mos to 1 yr) older dog/retired champion (check all that apply)
What characteristics are you looking for in a PWD?
Do you have any concerns or questions about the breed?
How long are you willing to wait for a PWD?	immediate 6 mos 9 mos over 9 mos (remember, a litter takes 4 mos from conception to 8 weeks old)
Please acknowledge:	Yes, I am aware that Avida PWD reserves the right to refuse to provide a puppy to any applicant for any reason.
How did you hear about Avida PWDs?:	A Friend Web Search Breeder's List Other source (please identify in comments below)
Comments: