Blue Moon Pomeranians Puppy Buyer Information Questionnaire
Please fill out the following questionnaire. Be specific and give as much detail as possible and then email, mail or fax it back to me at 903-852-5374. Please call before faxing, because the phone and fax are the same number.
These puppies depend on me to place them in a safe and loving home, and I will do my very best to do so. I love my babies from the day they are born and I hate to part with them, but if I’m sure they are in good homes, then I can rest easier. So please bare with me. Both you and I have to think of the puppy.
1. Family information:
Name ____________________________________________________________________________
Address __________________________________________________________________________
City: ________________________________ State: _____________ Zip Code: _________________
Home Phone: _________________________ Work Phone: _________________________________
Cell Phone: ___________________________ Best time to call: ______________________________
Email Address: ____________________________________________________________________
Place of Employment: _______________________________________________________________
How did you find us? _______________________________________________________________
How Many People in Your Household? ________ Ages of each: _____________________________
Are there any large dogs (over 10 pounds) in this household? ____ If so what breed? _____________
2. About the Puppy You Want:
Have you owned a Pomeranian before? ________ Do you want a Male? _______ Female? _______
What color are you looking for? _____________ Coat Type? Full, double coat ____ Medium _____
If you have owned a Pom before, do you still have him? ____ If not, what happened to him? ______
________________________________________________________________________________
How many hours a day will the puppy be left alone? ______________________________________
Where will the puppy be keep while you are away? _______________________________________
Will the dog be kept indoors or outdoors?_______________________________________________
Where will this puppy sleep at night? __________________________________________________
Why do you want this Pomeranian puppy? ______________________________________________
Are there any cats or other animals that can hurt the puppy, such as owls, eagles, hawks, snakes, in the area that he will be left alone?_____________________________________________________
3. Life with your puppy:
How much time will you spend daily with your puppy? ___________________________________
Do you plan to spay/neuter your puppy? _______________________________________________
What will you do with your puppy when you take a vacation? ______________________________
Who will be the care giver? _________________________________________________________
Are you prepared for the cost of taking the puppy to the vet on a regular and emergency basis? ____
What will you do if you can’t afford an emergency trip to the vet? ___________________________
________________________________________________________________________________
These little Pomeranians live to be as old as 17 years, are you prepared for this kind of commitment?
_______________.
Have you thought about who will care for your puppy in case of illness or death? _______________
Would you mind sending the breeder photos of your pup at 3, 6 and 12 months of age? __________
Do you mind being contacted ever so often to check on the pup and how you have bonded? _______
Can we use you as a reference to prospective buyers? _____________________________________
4. About your home and yard:
These little dogs love everyone. If they see someone across the road they will take off with lightning
speed to give some love and licks to a perfect stranger. So it is necessary to have some type of restraint.
Do you have a fenced yard? ________ Do you have a pool? _____ If so, is it fenced? ____________
What will you do if the puppy has an accident in the house? And it will happen until he reaches about
seven months of age. _________________________________________________________________
5.References:This is not required, but recommended.
Do you have a vet? ___________ If so can we contact him or her for a reference? _______________
Veterinarian Reference: Dr ______________________ Clinic phone number _____________________
Please list at least two people you can use as a reference.
Reference: Name ___________________________________________________________________
Phone Number: ____________________________________________________________________
Reference: Name ___________________________________________________________________
Phone Number: ____________________________________________________________________
Reference: Name ___________________________________________________________________
Phone Number: ____________________________________________________________________
Would you object to a visit to your home from us? __________________________________________
I have answered truthfully to all the information in this questionnaire to the best of my knowledge. I will provide a loving, safe home for my puppy.
Signature of Applicant: ________________________________ Date: ________________________
Thank you for completing this application. I know it is long and time consuming, but it is in the interest of the puppies. Your answers are very important to us. They help us place the puppies in the homes where they belong. I do not place my puppies in just any home to get rid of them. These are my babies and I treat them as such. The Pomeranian breed is such a loving, trusting little dog that their owners can do no wrong, so it’s up to me to place them where they won’t be hurt, but will be loved like one of the family. Thank you for your understanding.
Blue Moon Pomeranians
Charles Roberson
3117 VZ CR 4907
Ben Wheeler, Texas 75754
Home phone: 903-852-5374
Cell phone: 903-539-2888
Email: chasrob1@aol.com