City:   State:   Zip:
Phone:     Best Time to Call:
Email:     Fax:
Have you owned a Bernese Mountain Dog (Berner) before? Yes   No
How Many?
Have you any other breeds of dogs now? Yes   No
Other pets? If so, what kinds?
Why have you chosen a Berner?
Why do you want a dog?
Companion       Show
Obedience       Breeding
Draft or other performance events
Have you contacted other breeders? Yes   No
If so, whom?
Do you have children? Yes   No       What ages?
Do other family members want this berner also? Yes   No
Where do you live? City   Country
Where will this dog be kept? Indoors   Outdoors
Do you own your home? Yes   No
Do you have a fenced yard?Yes   No
What is your occupation?
What is the longest period of time each day that the Berner will be left alone?
Which do you prefer? Male   Female
Are you familiar with the health problems associated with
this breed? Yes   No
What are your concerns?
About how many hours a day will you be able to spend with your dog?
Where will the dog spend the majority of its time?
Where will the dog eat and sleep?
Have you ever raised a puppy before?
What form of discipline will you use?
Have you ever had to euthanize a pet, and what for?
Have you read books on the Breed   Animal Care   Training
Are you willing to take your puppy to obedience classes such as Puppy Kindergarten (ages 10 - 24 weeks) and regular obedience classes (ages 6 months and older)? If not, please explain why? Yes   No
Have you ever had any training or behavior problems with any dogs you have ever owned? Yes   No
Are you willing to crate train your puppy? Yes   No
If not, why?
Are you willing to spay/neuter your puppy? Yes   No
If not, why?
Are you willing to take this puppy to a Vet and follow his guidelines regarding vaccinations and health care? Yes   No
Are you willing to have hip and elbow x-rays done at the appropriate age? These usually cost around $125 to $250. Yes   No
Are you committed to providing high-quality care for this Berner for the rest of his life? Yes   No
I prefer to choose which puppy goes to which home. Do you have a problem with this? Yes   No
Please describe your lifestyle, including hobbies and other interests and tell me why you think I would like to place one of my Berner puppies in your home.