Lee Kennels
Puppy Questionnaire
If you are interested in one of our puppies, please fill out and submit the following questionnaire to us. Please allow two to three days for a response.
First Name
Last Name
Street Address
Address Line 2
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
Phone Number
Email Address
How Did You Hear About Us?
Were you interested in:
Our current available puppies
Being put on waiting list for upcoming litter
Being put on waiting list for future litters
What sex of puppy are you interested in?
Male
Female
No Preference
Do you have any children?
Yes
No
If so, what ages?
How many members are in your household?
1
2
3
4
5
6
7
8
9
10
Does any member of your household have allergies to dogs?
Yes
No
Not Sure
If yes or not sure, please explain what you will do to prevent an allergic reaction?
What type of residence do you have?
Apartment
Condo
Townhouse
Single-Family House
Other
What type of community do you live in?
City
Rural
Suburban
Do you rent or own?
Rent
Own
If you rent, do you have permission to own a puppy from your landlord?
Yes
No
Not Sure - Haven't Asked
Do you have a fenced yard?
Yes
No
If so, what type?
If no, how are you going to provide your puppy potty breaks and exercise?
Where will this puppy spend it's day?
Inside, loose
Inside, in crate
Doggy door, can go inside or outside freely
Outside, in fenced yard
Outside, tied up
Outside, in dog run
Both inside and outside
Doggy daycare
Other
Where will this puppy spend it's evening?
Inside, loose
Inside, in crate
Doggy door, can go inside or outside freely
Outside, in fenced yard
Outside, tied up
Outside, in dog run
Both Inside and Outside
Other
If other, please explain.
If inside, is there someone home during the day or able to get home to allow the puppy potty breaks?
Yes
No
On average, how many hours will the puppy be left alone in a day?
1 Hour
2 Hours
3 Hours
4 Hours
5 Hours
6 Hours
7 Hours
8 Hours
9 Hours
10 Hours
11+ Hours
Are you willing to attend private or group puppy training classes with this puppy?
Yes
No
Not Sure
Are you planning on having the puppy spayed/neutered?
Yes
No
Please give us the name, address and phone number of your vet (or one that you have worked with in the past).
Do you mind if we contact them for a reference?
Yes
No
What is the purpose this puppy will provide?
Family Pet
Show/Events
Breeding
Other
If other, please explain.
Have you owned a Rat Terrier or Teddy Roosevelt Terrier before?
Yes
No
What attracts you to this breed?
What don't you want in a Teddy Roosevelt Terrier?
What type of personality are you looking for in a puppy?
Do you currently own other pets?
Yes
No
If so, what type?
Please give us any other information you think will help us get to know you and your needs with respect to placing a puppy most suited to your family/lifestyle.
Have you read and agree with the "Sales Agreement"?
Yes
No
If you would like a copy of the submitted questionnaire sent to you, please provide an email address.
Indicates Response Required
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