Please complete the following information and return to me
HAVACASA HAVANESE
Susan Murphy
havacasahavanese@
Please complete the following information and return to me. All information
provided will be kept confidential.
Your name:
Your street address:
Your city, state and zip:
Your e-mail address:
Phone number:
You are looking for a puppy of what sex?
__ female
__ male
__ female, would consider male
__ male, would consider female
__ no preference
Are you looking for a specific color?
__ yes (if so, what color? _______________)
__ no
__ prefer _______ but willing to consider others.)
For what purpose are you interested in a Havanese? (check all that apply)
__ family pet
__ obedience
__ conformation shows
__ agility
__ breeding
Any puppy sold as a pet will be sold with AKC limited registration and
spay/neuter agreement. Are you willing to agree to this?
__ yes
__ no
Have you spoken with any other Havanese breeders?
__ Yes
__ No
Are you aware of the few physical problems currently found in Havanese?
__ Yes
__ No
Have you and your family ever met and played with a Havanese?
__ Yes
__ No
Do you have children under the age of 5?
__ Yes
__ No
Do you live in:
__ apartment
__ house
__ townhouse
__ other (please specify _________________________________)
Do you rent or own your residence?
__ Rent
__ Own
Do you have a fenced yard secure enough to hold a dog?
__ Yes
__ No
If not, how will you provide security for your puppy when it is outside or
when you are not at home?:
Is there someone home during the day, or is anybody able to get home to
potty a puppy?
__ Yes
__ No
Where will this puppy spend the day?
__ Outside, in the yard
__ In the house, confined to a puppy-proof area
__ In the house, loose
__ In its crate
__ Other (Please specify _______________________________________________)
Will the puppy have regular contact with the family during the evening?
__ Yes
__ No
Where will the puppy sleep?
__ In its crate, in the bedroom
__ In its crate, in (fill in room) ________________
__ In bed with us
__ In the garage
__ Outside
__ Other (Please specify) ____________________________________
Are you willing to attend group training classes with this dog?
__ Yes
__ No
What breed(s) of dog do you have or have you owned? If you haven't
owned a dog before, please so state. How many dogs and cats do you
presently have?
If any of the dogs previously owned are deceased, what were the
circumstances ?
Who will have the primary responsibility for the care of this puppy?
Please give the name, address and phone number of your vet (or one that
has worked with you in the past):
Have you ever given a dog up to a shelter or pound? If so, why?
What kind of diet (brand name) do you think you will feed your puppy?
What do you expect from a puppy? For example, would you prefer a very
active, outgoing dog or a quieter, more laid back pup? Please take a little
time to tell me what your ideal dog would be like:
I apologize for the length and detailed nature of this questionnaire, but I do
my best to improve this breed and that includes finding the optimal family
conditions for my puppies. I believe strongly in prevention rather than repair.
The best way for me to make a successful placement for one of my pups is to
match it, with its individual temperament, to a family whose personalities and
lifestyle will suit it and appreciate its unique qualities.
Please feel free to add any comments and/or questions here.
Thank you for your patience. I look forward to discussing this further with
you after receiving your reply. My puppies are raised in the house and are
thoroughly socialized.
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