Puppy Questionnaire

At this time we are not comfortable selling pups outside the United States.

All puppies are sold on AKC co-ownership

Please feel free to fill this out if you are interested in a puppy of ours or would like us to refer you to a breeder with puppies currently.

Thank you

- Kellyn

Name:
Email Address:
Phone:
Address:
Occupation:
Name & Age of Household members:
Who will be responsible for the dogs care:
Is someone home during the day:	Yes No
If no how is this handled:
Do all family members want a dog:	Yes No
Are any members of the household allergic to dogs:	Yes No
Do you	Own Rent Apartment Townhouse House
Yard size and Fencing Type
Have you ever owned a dog? When? What happened:
What pets do you presently own:
Have you met a Clumber Spaniel in person:	Yes No
When/ how did you become acquainted with Clumber Spaniels
Do you understand Clumber Spaniels shed, slobber and are a truly large breed dog:	Yes No
Do you understand that Clumber Spaniels MAY submissive urinate until maturity	Yes No
What makes you think a Clumber Spaniel is right for you:
Dog will be housed:	Indoors Outdoors
Do you plan on crate training:	Yes No
Who will take care of the dog when you are gone for extended periods or vacations:
How will the dog be confined in your absence:
Veterinarian’s name, Address, Phone:
Your puppy will require housetraining, socialization, training classes, daily exercise and weekly grooming. It will be much like having a new baby in the way it disrupts your life. Do you understand the time, energy & commitment required to get a puppy through its first year?	Yes No
What will you do to get through this:
Will you take the puppy to socialization and obedience classes:	Yes No
Will you allow for a home inspection by either Chequamegon or one of its friends prior to the sale of the puppy:	Yes No
In placing dogs with buyers, I consider this agreement a pact between parties to secure the dog’s welfare for its lifetime. In this agreement, I offer lifetime refuge for any dog I produce which buyer cannot keep. Will you promise to return the dog to me should some unforeseen circumstance prevent you from keeping the dog any longer with no monetary refund?	Yes No
Would you have the hips & elbows evaluated by OFA at 2 years of age & a CERF (eye) exam done between the ages of 1 year and 3 years of age:	Yes No
Your preferences on a puppy:
Age:
Would you spay/neuter: We DO NOT recommend spay/neuter before the age of 2 for the reasons contained in the article the LongTerm Health Effect of Spay/Neuter (click here to read).	Yes No
Preferred gender:	Male Female No Preference
What do you want to do with your dog:	agility companion conformation (show) hunting obedience therapy tracking other
If other please explain:
Please give Kellyn a call after completion to speak about what you are looking for. 715-688-9099