K&H Havanese Puppy Owner Questionnaire
We have all prospective puppy buyers fill out the following questionnaire to enable us to determine the right placement for our puppies. Not every puppy is right for every family, and we do our best to get the right "fit."

If you wish to be put on a mailing list to be notified when we have puppies available, please fill out the following form and click Send.

If you have any questions, please email us at khhavanese@bellsouth.net
Please fill in all fields.

Date:
First Name:  Last Name:
Street Address:
City:  State:
Zip:
Country:  Other:
Email:
Home Phone:
Type of Dwelling: House   Condo/Townhouse   Apartment   Mobile Home
Who will be the primary caregiver?  
Do you work?   Yes   No  Full-Time or Part-Time:   FT   PT
If you work, how long will the puppy be left alone during the day?  
Less than 4 hours   4-6 hours   6-8 hours   More than 8 hours
Will someone be available to feed & walk the puppy during the day?   Yes   No
Have you ever owned a dog before?   Yes   No
If yes, what kind?    How long?  
If you no longer own the dog, why not?  
Does anyone in your household have allergies to animals?   Yes   No
If yes, to what and how severe?
  Have you consulted with a doctor about getting a dog?
Are you interested in a:   Male   Female
Preferred age:   Does not matter   Puppy   Adult
How active is your household, and what are your expectations about the energy level of a Havanese?  
Minimum   Moderate   Active
Will you be attending any training classes?
Yes   No 		 Beginning at what age for the dog?
Are you interested in competing with the dog in conformation, agility, and/or obedience? (check all that apply)  
Conformation   Agility   Obedience
Have you ever shown a dog to its Championship?   Yes   No
Do you plan to breed this dog?   Yes   No
Do you understand the difference between a limited and a full registration?   Yes   No
Are you willing to sign a spay/neuter contract if purchasing a pet?   Yes   No
Are you willing to have your Havanese's eyes examined annually by a veterinary opthamologist and send the results to CERF?  
Yes   No
If you have children, what are their ages?  
Questions/Comments for us:

<% end if %>