CHINESE SHAR-PEI
Puppy Inquiry Questionnaire

CHAOYANG CHINESE  SHAR-PEI
GLEN and LINDA COSIER
32 FOXFIRE CHASE
UXBRIDGE ONTARIO L9P 1R4
(905) 852-1586
chaoyangcsp@sympatico.ca

Instructions:  Copy and paste this text into an e-mail, fill it out and send it to chaoyangcsp@sympatico.ca

Name: 

Street Address: 

City:              Prov./State:       Postal Code/ Zip:

Home Phone:                       Work Phone: 

E Mail address:  

Name of Co-Applicant: 

Relationship:   Spouse  (   )  Parent  (   )  Child (   )  Roommate (   )     Other (  )

1)      How did you hear about our Chinese Shar-Pei?

2)      What do you know about the breed  (temperament, health, etc.)?

3)     Do you have a preference in coat, colour, sex or age? 

4)      Do you rent or own your own home:  

5)      What type of home do you live in?

Apartment (  )  House   (  )  Duplex  (   )  Mobile Home  (  )  Condo  (  )  Other  (  )

6)      If you rent, please provide us with the landlord’s name and phone number.

            (Please note that we will contact your landlord)

7)   How long have you lived at this address?   

8)  Are there any covenants (restrictions, size, number, type) that prevent you from having a particular pet? If yes please explain. 

9)    Who will be responsible for the care of this dog?

10)    If you have children living in your home or that visit on a regular basis, please indicate their ages.

11)   How many hours will your dog be alone per day? 

12)    Who will care for this dog while you are on vacation? 

13)    If you have to move what will you do with your dog? 

14)    Are you willing to take responsibility for this dog for the next 10 or more years? 
  Even if you have your first or more children or pets? 

15)    Will this dog be taken annually to the veterinarian for  a check-up and be checked for parasites and

heartworms?     Yes (  )    No  (  )

16)  Have you ever owned a Chinese Shar Pei? 

17)    If you have owned animals in the past, what happened to those animals?

18)    If you have other animals, please fill out the sections below.

Breed/Type                Age           Spayed or Neutered

Breed/Type                Age           Spayed or Neutered

Breed/Type                Age           Spayed or Neutered

19)    Please provide the name and address of your veterinarian.  We will call them for a reference.

20)    Do you have a fenced yard?

21)    What kind of fencing do you have?

22)    If you do not have a fenced yard how will your Shar Pei be exercised?

23)    Where do you plan on keeping your Shar Pei the MAJORITY of the time?

24)    Where will your dog sleep at night? 

25)    What will you do with your dog when there is no one at home?

26)    What will you do if your dog exhibits bad behavior?  i.e....being destructive, Soiling the  house, barking, etc?