If I do not have the puppy you want do I have your permission to forward your questionnaire to a breeder who might?
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Yes
No
Ask me first
Referred by
First Name
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Last Name
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Primary Email
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Address
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City
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State
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AL
AK
AR
AZ
CA
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CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
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MO
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NH
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OR
PA
RI
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Country
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Abkhazia
Afghanistan
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Anguilla
Antigua and Barbuda
Argentina Argentina
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Chad
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Republic of China
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Cocos (Keeling) Islands
Colombia
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Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana Guyana
Haiti Haiti
Honduras
Hong Kong
Hungary
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India
Indonesia
Iran
Iraq
Ireland
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Italy
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Japan
Jersey
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Kenya
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South Korea
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Laos
Latvia
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Liberia
Libya
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Lithuania
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Mali
Malta
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Mayotte
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Netherlands
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Niue
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Paraguay
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Poland
Portugal
Transnistria Pridnestrovie
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
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South Ossetia
Spain
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Sudan
Suriname
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Swaziland
Sweden
Switzerland
Syria
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
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United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Years at this address?
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Residence
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Single Family
Two Family
Apt/Condo
Farm
Trailer
Other
If other what type
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Home Phone
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Work Phone
Cell Phone
Are you willing to permit a home check?
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Yes
No
Do you have a fenced yard?
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Yes
No
If so, please describe.
Are you married?
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Yes
No
Do you have children?
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Yes
No
If you have children please list how many and their ages.
Does anyone have allergies?
Yes
No
If yes, who, to what and how severe?
Is everyone in your family completely committed to getting a Great Dane?
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Yes
No
Have you considered rescuing an older puppy or adult?
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Yes
No
Have previously adopted a rescue.
Do you currently own dogs?
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Yes
No
If Yes, How many, breed, sex, and age of dog(s)
Are they spayed or neutered?
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Yes
No
Not All
If No, why not?
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Have you had dogs before?
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Yes
No
If Yes, What breed(s)?
If Yes, what happened to them?
Do you have any other animals?
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Yes
No
If Yes, What type?
Have you ever given a pet away?
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Yes
No
If so, what were the circumstances?
Why do you want a dog?
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Why are you interested in Great Danes?
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Are you willing to travel for your new puppy?
Yes
No
Depends on distance
How familiar are you with Great Danes?
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Are you aware of the yearly costs of maintaining a healthy dog?
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Yes
No
Veterinarian (name, address & complete phone number)
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24 Hour Emergency Facility (name, address and complete phone number)
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Do you have a preference about male or female dog?
Male
Female
No Preference
If your puppy is to be a pet are you willing to spay/neuter?
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Yes
No
If your puppy is a pet are you willing to work with your breeder regarding the appropriate age to spay or neuter?
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Yes
No
Why do you prefer the gender that you do?
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Do you have a color preference?
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Black
Blue
Brindle
Fawn
Harlequin
Mantle
Merle
No preference
Do you have a preference for cropped or uncropped ears?
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Cropped
Uncropped
No Preference
Are you willing to consider the opposite ear style you chose above?
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Yes
No
Are you willing to work with your breeder regarding aftercare and taping of cropped ears
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Yes
No
Not Applicable
Are you willing to work with your breeder regarding feeding and vaccination protocols?
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Yes
No
Are you willing to travel to pick up dog?
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Yes
No
Are you interested in showing in the conformation ring?
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Yes
No
Have you ever shown a dog to it's championship?
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Yes
No
Are you interested in competition in performance events such as obedience, agility, hunting, herding, etc.?
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Yes
No
Have you shown a dog to any performance titles?
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Yes
No
Who will be primary caregiver?
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How many hours will the dog be left alone per day?
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Where will dog stay when alone?
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What kind of floor surfaces will the dog be on in the house?
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Does your family travel?
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Yes
No
Where will the puppy/dog be kept during the night?
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Where will the puppy/dog be kept during the day?
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Is anyone home during the day, and if so, who?
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