***Please fill out the ENTIRE form.***

YOUR PERSONAL INFORMATION

Full name:

E-mail:

Telephone #:

Home address:

City & state:
City State

Postal zip code:

1. Do you own or rent?:
Own Rent

2. Number of adults:

3. Number of children & ages:
# of Children Ages (separate by commas)

4. Do you or any member of your family have allergies? If so, please explain:

5. What pet(s) do you have now? Please list type, age altered, etc.

6. What is the name & phone number of your veterinarian?
Name: Number:

HOME ENVIRONMENT

1. Do you have a fenced in yard?
Yes No

2. How long per day will your great dane be alone?
Hours

3. Where will he/she be kept when alone?

4. How many walks per day?
1 2 3 4

5. Where will he/she sleep at night?

6. Are all members in the household aware that you would like to have a great dane?
Yes No

7. We want a great dane to be a part of our family because:

NEW DOG INFORMATION

1. Have you ever had a great dane before?
Yes No

2. Have you ever owned a giant or large breed before?
Yes No, If so, what breed?

3. Why do you want a great dane?

4. What qualities, personality wise, do you expect of a great dane?

5. What do you estimate it will cost monthly to feed your dane?

6. Would your new puppy be spending most of it's time indoors or outdoors?
Indoors Outdoors

7. DANES ARE VERY BIG, VERY STRONG DOGS!!! Are you willing to make the commitment to this puppy to enroll him/her in puppy classes?
Yes No

8. All of our danes come with a spay/neuter contract. Are you willing to get this done by the time the puppy is 7 months old & show proof of this?
Yes No

9. Because they are an extra large breed, vet expenses are higher (heart worm, antibiotics, etc.) Will you be ready to afford the much higher vet bills that danes require?
Yes No

10. What sex of puppy are you interested in?
Male Female

11: What color puppy are you interested in?

THANK YOU FOR SUBMITTING THIS QUESTIONNAIRE