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First Name

Last Name

Phone Number *

Email *

Address *

Has everyone in the family discussed and agreed on getting a new dog? *

Who will be primarily responsible for the dogs care?

Are you financially prepared to provide regular veterinary care?

Do you need a referral for veterinary care? *

Are there children who live in your home? *

Are there children who visit your home? *

Do you currently have other animals? *

Do you own or rent your home? *

Current residence is? *

Please describe fencing in the yard or exercise area where your dog will be outside *

Indicate height of your fence at its lowest point *

Do you have any known hazards, such as poisonous plants, outside electrical wire, or an unfenced pool with no way for the dog to climb out? Are there any structures that would allow your dog to climb out of the exercise yard? *

How much time per day do you plan to exercise your dog? What type of exercise? *

Why do you want a German Shepherd Dog? *

How long will your dog be unsupervised without human companionship during the typical weekday? *

Where will your dog spend most of its time? *

Where will your dog sleep at night? *

What type of dog would you prefer? *

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