Your Name (required)

Your Email (required)

Contact Number (required)

Your City (required)

State (required)

Are you interested in a: (required)
Puppy (12 weeks plus)Older Puppy (4 months +)Adult

Do you have a specific puppy you are interested in? If so which one: (required)

What are your plans for the Chihuahua? Please list all that apply (required)
Pet Companion OnlyShow PuppyBrood BitchStud ShowTherapyObedienceAgility

Are you familiar with the Chihuahua breed? (required)
YesNoA Little

Is the puppy for you or for someone else? (required)

What type of dwelling do you live in? Do you own or rent? (required)

Do you have permission to have a dog? (required)
YesNo

Do you have any other pets? If so, please list ages and breeds. (required)

Have your current pets been spayed/neutered? (required)

Do you understand all of our pets (puppy/adult) unless for show/breeding are sold on limited AKC registration under spay/neuter contracts? (required)
YesNo

Are you familiar with the possible health issues related to Chihuahuas? (required)
YesNoSomewhat

How long are you willing to wait for a puppy? (required)

Any other information you feel I should consider? (required)

Please supply your Veterinarian’s contact information: (required)