Puppy Questinnaire — Wiggle Butts PA

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number

Number of children in the house & ages?

Current pets (all species and breeds)

Past pets (all species and breeds)

Describe your lifestyle, family, and any other things you’d like to share.

Housing situation (ex. House, apt, rent, own, containment for animals)

Who will be the primary caretaker? If not you, who?

We do not give breeding rights on any of our puppies and they are to be altered before the age of 2 yrs please note AGREE below to move forward.

Puppy Preferences: PLEASE ANSWER COMPLETELY - Specific litter, Gender, Color, Pick up/drop off options

What activities, if any, will you plan to do with your puppy?

How long will your puppy be left alone at any given time?

Puppies that leave here are always welcome back for any reason. They are not to be rehomed without notice given to breeder and are NEVER to be given to any shelters/rescue organizations. Please note AGREE if you acknowledge this statement.

Our puppies are not to be outdoors for any extended period of time. Meaning, that their time is not to be spent outside penned or chained 24/7. These puppies are raised indoors with their humans, and we trust that they will also continue to be raised that way when they leave. Obviously if you are outside and doing chores, or hiking, or playing with you and your family. Please mark AGREE if you acknowledge this statement.

Do you have breed or breed type experience?

What kind of training are you prepared to do with your new puppy?

Please leave your full physical address.