AKC Breeder of Merit

Prospective Owner Questionnaire

Please provide the following contact information:

1. Name:*
2. Significant Other:
3. Address:
4. Home Phone:
5. Cell Phone:
6. E-mail:*
7. Other E-mail:
8. Your Age Range:
9. Are you primarily looking for a :
10. Would you be interested in an adult or older dog?:
11. Have you ever owned a Cavalier King Charles Spaniel?:
12. If yes, from whom did you obtain it?:
13. If you no longer have it, what happened to it?:
14. Was/is it a:
15. What color?:
16. What made you decide to explore purchasing a Cavalier King Charles Spaniel?
17. Do you prefer a:
18. Why?:
19. What color(s) do you prefer?:
20. If you currently have other pets, please list their name, breed, age, sex and whether they are spayed/neutered.:
21. Please list any prior dog owning experience, breeds owned and what happened to these dogs. :
22. If you have children, please list their names and ages and describe their experience with dogs. If you don't have children now, do you plan to in the near future?:
23. Were there ever any problems between your children and dogs? :
24. Do you have a fenced yard?:
25. How do you plan to exercise your cavalier? How often? :
26. Do you have a certain area where you plan on keeping your cavalier? :
27. Have you ever crate trained a puppy?:
28. What time periods during the day will your cavalier be left alone? :
29. Are you aware of the interaction needs of a cavalier, and do you feel you are capable of providing for these needs? :
30. How many total people live in your household?:
31. Are you employed? If yes, where?:
32. Is your significant other employed? If yes, where?:
33. Please list any other breeders you are currently on a waiting list with. :
34. How much study have you done on cavaliers? Please list any books you have read.:
35. Please list the health problems that you are aware of that cavaliers can be afflicted with. Which is your biggest concern?:
36. Are you willing to allow the breeder to request health testings to be done annually to gather information for the future breeding of cavaliers? :
37. What veterinarian will you be taking your cavalier to?
38. How did you hear about us?:
39. Do you rent or own your home?:
40. If you rent, is your Landlord in agreement with your acquiring a dog?:
41. If you rent, please list your property owners name and phone number:
42. Does anyone in your household have any allergies to pets?:
43. Do you understand that spaying and/or neutering would be required as part of the contract? Do you have any concerns about this?:
44. Please list two references (neighbors, or close acquaintances) Please include either their phone number or email:

Thank you for taking the time to answer these questions. It does not obligate either you or me. It is my hope that it will help in our communications thereby placing the right personalities together  for the most successful family match.

Date Submitted:*
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