Name:        Occupation:
Name:         Occupation:
Other family members’ names and ages:
Address:
City:   State:    Zip:
Phone:   E-mail: 

1.  How did you find out about Heatherstone Welsh Springer Spaniels?

2.  Why do you wish to have a Welsh Springer Spaniel?

3.   Do you wish to have a male or female ?    
If the gender that you desire is not available, are you flexible with your choice? Yes   No

4.  What activity (ies) do you wish to do with your Welsh Springer Spaniel??
Companion Hunting Obedience Agility Tracking Show/Breeding Pet-Assisted Therapy

5.  Please describe your home: (i.e.  single home, duplex, townhouse, apartment, etc.)

6.   Does your property have fencing? Yes    No  If so, what type and how high?

7.  How do you plan to exercise your dog?

8.  Where will your dog sleep?
9.  Where will the dog stay when you are not at home?
10.  Where will your dog be permitted in your home?  Are there dog-free areas that the dog will not be permitted to be in?

11.  Have you ever crate trained a dog previously?    What is your feeling about crates?

12.  Where will your dog stay when you are on vacation or have a need to travel?

13.  Who will care for this dog when you are not at home or travel?  

14.  Describe any previous dogs that you have had and your experiences with them?  

15.  Do you have any other dogs, cats, birds, reptiles or other pets now?

16.  Please tell me about your previous dog training experiences and the availability of training classes in your area.

17.   Do you currently have a veterinarian that you use?  
18.  Have you considered the total cost of pet ownership?     Have you thought about the following:  Initial cost, veterinary visits, annual heartworm testing and monthly preventative, monthly flea and tick preventative, training classes, dog food, supplies, toys, etc.?
What are your feelings about these costs? 

19.  In the event that your dog were to become ill, how prepared are you to deal with the financial expenditure necessary to return your pet to normal health? 
20.  How would you deal with the following situations:
You return home to find your dog has chewed up everything in sight?

You return home to find that your dog has urinated/defecated in the house?

Your dog digs holes in your yard, digs up flowers, bushes, etc.?

21. If your dog were diagnosed with epilepsy, severe/crippling hip dysplasia, eye disease and/or hypothyroidism, what would your response be?

22.   If your dog were to manifest signs of separation anxiety, what would your response be?

23. All Heatherstone puppies must be picked up in my home. Are you prepared to make the trip to West Virginia to do this?
24.   Are you prepared to have your dog’s health clearances performed (hips x-rayed and OFA certified, eyes checked and CERF’d, thyroid level drawn and certified by OFA) at the age of two years old?

25.   What do you plan to feed your dog? 
26.   What do you plan to do in terms of vaccinations for your dog?