aaamaltesebeautues.zoomshare.com Maltese Puppy Screening Questionaire Thank you for considering one of our puppies to add to your family. We invest much love and time in breeding them. If you would like to be considered for one of our puppies, please feel free to cut and paste this page to an email, fill out the questionaire and we will get back to you promptly. Should you be unable to email this form, please contact us. Name:____________________ Address:_______________________________________ Home Phone:________________Work phone:___________ Best time to call:_____________ Email:___________________________________ Occupation:___________________________________ HOUSING/LANDLORD INFORMATION Do you own or rent your home?_____ If you rent, do you have the landlord's permission to keep a dog?_____________ Landlords permission must be obtained! Do you live in a :___House___Apartment___Townhouse Other How long have you lived at this address?___________ HOUSEHOLD INFORMATION How many adults in the house hold?________ Children?______ Age and gender of children:__________________________________________ ___________________________________________________ Who in the house will have the main responsibility of caring for this pet?____________________________ How many hours a day will the dog be alone?________ Please descibe your lifestyle: __Active__Passive __In-between OTHER ANIMAL INFORMATION Do you own other dogs?___Yes___No Spayed/Neutered?__Yes__No Please list breed, size, and gender of each:______________________________________________ ___________________________________________________ Do you own cats?___Yes___No If yes, how many? _____ Declawed?___Yes___No Any other animals?___Yes___No If yes, please describe:__________________________________________ ___________________________________________________ How many dogs have you owned in the past five years?__________ If you do not still own the dog(s), please describe what happened to it(them). Please be specific.__________________________________________ ___________________________________________________ ___________________________________________________ Have you ever returned a pet to a breeder?__Yes__No Have you ever given a pet away?__Yes__No If so, what were the circumstances? ___________________________________________________ ___________________________________________________ Have you ever taken a pet to the pound or shelter? __Yes__No If so, what were the circumstances? ___________________________________________________ ___________________________________________________ Have you owned a maltese dog before?__Yes__No Why did you choose this breed? ___________________________________________________ If you are not approved for a maltese puppy from this litter, would you consider choosing an adult maltese dog?__Yes__No What activities do you plan on doing with this dog? ___Pet___Obedience___Aglilty Will you be attending training classes?__Yes__No Do you plan on keeping this dog primarily? ___Indoors ___Outdoors Where will the dog sleep?________________________ Do you have a regular vet?__Yes__No Name:____________________Phone:________________ Address:____________________________________ PREFERENCES What age puppy would you like to get?__________ Which do you perfer?__Male puppy__Female puppy Will you be willing to abide by the aaamaltesebeauties mandatory NO BREEDING provision?__Yes__No Thank you for investing this time in your search for a new puppy.