Puppy Adoption Questionaire

Please note that completion of this questionaire does not indicate an agreement on your part to adopt a puppy, nor does it indicate an obligation on my part to place a puppy with you or anyone else. This is simply a tool for me to get to know the prospective families of the puppies being whelped.

General Information

Your full name:  

Your email address:  

City, State/Province  

Phone Number  

How did you hear about Hokus Pokus?  

Your Lifestyle

Tell us a little about your lifestyle: experience with dogs, work schedule, hobbies, etc . . .

How many adults live in your home?  

How many children live in your home?           What are their ages?  

Any other pets?  

Where do you live?  

Do you have a fenced yard?  

Would you be willing to abide by a written contract as a condition of your adoption?  

Your Prospective Puppy


  Are you looking for a . . .   

Male        Female

Hairless        Powderpuff

"Show Quality" dog        "Pet Quality" dog   


Where would this dog live?  

Other Important Information

Please list two personal references and their contact information; and if you've ever owned a dog, please also include your veterinarian's contact information.

Please use this space to express any other information, comments, or concerns you have; or more information regarding the answers to the questions above.