HavDiss Havanese Puppy Questionnaire
Why fill out this lengthy questionnaire?
It is to protect you and our “puppies to be.” We are preparing to place one of our litters and our dogs are part of our family. It is important to us to make sure that our Havanese will be loved and well cared for. We want to place the right puppies in the right homes and this questionnaire will help us to make the best decision. Believe me when I say that if you are not required to fill out a puppy questionnaire when purchasing a Havanese, you may be surprised at the health and quality of your new pet.
I filled out this same questionnaire many (almost 20) years ago. There are no right or wrong answers.

Christianne and Jim Disser
HavDiss Havanese
www.havdisshavanese.com
e-mail: chrisdisser@gmail.com
phone : 936 520-2242

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Name *
Address *
City *
State *
ZIP *
Phone *
Email *
Primary Owner Occupation/Employer *
Spouse/Partner Occupation'/Employer *
Referred by
Type of Dwelling *
How long have you lived at this address? *
Do you have other pets in the family? If so, please tell us a little about them. *
What are your expectations and/or concerns about getting a Havanese? *
 Briefly explain why you think you would provide a great home for a Havanese: *
Who will be the puppy’s primary caregiver? *
On average, how long will your puppy be left alone? *
Where will the puppy be kept during the night? *
 Do you have a fenced yard? *
Required
 If no, please explain your arrangements for allowing outside access. .
Have you ever owned a dog before? If so, tell us more about your experience with this dog (what kind of dog, how long did you own the dog, etc.). Also, if you no longer own the dog, please tell us why. .
Have you ever turned a dog over to a pound/shelter or returned a dog to a breeder before? If so, please explain the situation.
 If you were ever in a situation and found yourself unable to care for the dog, who would take over the dog’s care?
Does anyone in your household have allergies to animals? If so, to what kind? Also, have you consulted with your physician regarding the new puppy and/or have you visited with a Havanese in person to check for allergy sensitivity?
What is your time frame for obtaining a dog? *
 Do you own (or co-own) other Havanese? If so, please tell us about them.
Are you interested in a male, female or either? *
Preferred Age? *
Are you going to show in Conformation?
Are you going to compete in Performance Events with your Havanese
Agility, Rally, Obedience, Tracking
Do you plan to attend training classes with your Havanese?
Have you ever shown a dog to its championship or in other performance events such as obedience or agility? If so, please tell us about your showing experience
If this dog is of show quality, would you be interested in having the dog shown by the breeder or other handler to it’s AKC championship?
Do you intend to breed this Havanese? *
Required
 Do you understand the difference between a full and limited registration?
Tell us more about the research you have done into the Havanese breed. Are you aware of health concerns?
Are you willing to have your Havanese’s eyes examined annually and to register the results with CERF?
 If you do not live nearby, are you willing to travel to Houston to pick up your puppy or do you have other arrangements?
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