RoseWynd

Rosewynd Questionnaire

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

-Jill Holt

(Members in good standing of the ACA)

Name:
Email Address:
Phone Number:
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: (you may select more then 1)	Own Rent/lease Apartment Townhouse House
Yard size and Fencing Type
Have you ever owned a dog? When? What happened:
What pets do you presently own (age breed & gender):
When/ how did you become acquainted with Akitas
Do you understand Akitas blow coat, can slobber, have a two yr puppyhood	Yes No
What makes you think an Akita is right for you:
Dog will be housed:	Indoors Outdoors Indoor/Outdoor
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 Rosewynd 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 little or no monetary refund?	Yes No
Your preferences on an Akita:
Age: (older dogs sometimes available)
Would you spay/neuter:	Yes No
Preferred gender:	Male Female Either
What do you want to do with your Akita:	agility companion (pet) conformation (show) obedience therapy other
If Other please specify:
Initial here to verify that all information is accurate.
Thank you for your time
We will get back to you hopefully within 48 hours with a phone call. -Rosewynd

Photos and text cannot be used without express written permission of Jill Holt.

Rosewynd Questionnaire

Thank you for your time