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Jillybean's Shih Tzu Shoppe 2008-2010. All Rights Reserved. Site designed and maintained by Willow Bend Designs
Jill ~ Baytown, Texas ~ 281-424-5773 ~ jillybeanstzu@aol.com
Name
Questionnaire
Address
City, State
Zip
Home Phone
Work Phone
Cell Phone
Email Address
1. If you purchase a puppy from me, would this be your first pet?............................................
2. Do you have other pets?...............................................................................................................
3. If yes, list breed and age.............................................
4. Do you have a Veterinarian?........................................................................................................
5. Have you ever owned a Shih Tzu?...............................................................................................
6. Do you want a male or female?..................................................................................................
7. Do you understand that Shih Tzu require daily brushing and trips to the Groomers
which could be pricey?...........................................................................................................
8. Are you prepared to care for this puppy for 10-18 years?....................................................
9. Is everyone in the home in agreement about getting this puppy?.....................................
10. Do you have children? If so, what are their ages?................................................................
11. Do you rent or own your home?................................................................................................
12. Do you have a fenced in yard?..................................................................................................
13. Who will be the primary caretaker of this puppy?................................................................
14. How many hours a day will the puppy be alone?..................................................................
15. Where will your puppy sleep during the day/night?.............................................................
16. Have you ever given up a dog to a shelter or rescue?........................................................
17. Do you understand that your deposit guarantees that the puppy will be on hold for
you and the deposit is NON-REFUNDABLE?..................................................................
18. Do you agree to spay/neuter your puppy by the age of 6 months and that I MUST
receive proof from a licensed Vet before I send AKC papers for registration?....
19. If you purchase a puppy from me, do you understand that the puppy MUST be seen
by a licensed Vet within 72 hours of your purchase?...............................................
20. Have you read and understand the articles on my website about Hypoglycemia
and Parvo?........................................................................................................................
Thank you....I will be in contact with you!
Please tell us a little about you and your family and why you would like to adopt one of our precious little pupcakes.
