Name:
E-Mail:
Phone:
Address:
Address:

Will you be the owner of this dog/puppy? yes no
If not, whom are you getting this dog/puppy for?
Are they aware of your action and in agreement? yes no
If so, please have them respond to this questionaire.

What are your living arrangements? home apartment
Are you urban suburban rural
Is this your permanent living arrangement? yes no

Do you have a fenced in yard? yes no
If no yard, then how will the dog be exercised?

Describe your lifestyle, i.e, active-hiking, skiing, other activities which would include the pet,
or social, dog accompanies you on picnics, neighborhood events, etc., or somewhere in between.

Have you had a dog in the past? yes no
Have you had a puppy in the past? yes no
Did you raise the puppy? yes no
What was the breed(s)?
How long did they live?
Do you currently have a pet(s)? yes no
If so, what kind, their ages, and sex? Is this pet(s) spayed or neutered ?

What is the reason(s) for deciding on a Samoyed?

Are you looking for a puppy or an older dog? puppy dog age neutral
What is the gender you want? male female gender neutral
What is your expectation of this Samoyed?
companion pet therapy obedience show sled or other
Have you considered how you will house break the puppy or dog?

What is the composition of your household, ages, etc.?
Are the family members supportive of this decision and willing to help?
yes no
Please describe any medical conditions such as allergies, mobility difficulties.
Please describe how this Samoyed will live - inside/outside, where it will sleep at night, plans for crate usage, dog's life while you are at work, vacations, etc.

If this dog/puppy are not show quality, are you willing to have them spayed/neutered?
yes no
Are you prepared for the ongoing costs of pet ownership? yes no
How much do you estimate spending annually, for feed, vitamins, grooming, veterinary expenses, toys, kennel or pet sitting, emergencies, etc?
Please provide the names/telephone numbers of 2 references, how they are associated with you, and your veterinarian if any.

1
2
Vet
If you reside in a rental property, please provide landlords name/phone contact information.

How did you hear about Misty Mountain Samoyeds?

Thank you for your interest in our Samoyeds.

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