Bernese Mountain Dog Adoption Form We would like to thank you for your interest in our Bernese Mountain Dogs. We are always open to questions about us, our breeding program and the strengths and weaknesses of our dogs. Please complete the questionnaire and send it back to us. This question sheet is one of the ways we begin to get to know prospective families and the characteristics that are important to them in a puppy and breeder. Your time and honesty will ensure that our puppies and new families are successfully matched and have a lifetime of cherished memories. Name:__________________________________________________________________ Address: _________________________ City/State: ________________ Zip: _________ Rural: _____ Suburban: _____ Urban: _____ House: __________ Apartment: __________ How long at current address: _____________ Fenced Yard: ________ Where/How will you exercise your pet: ____________________ Contact Phone Numbers: ___________________________________________________ Email: _______________________________________ How were you referred to BLUE SKY BERNERS:_______________________________ Age of Primary Care Givers: 18-2526-3536-45 46-55 55-older Marital status: ___________________ Occupation: _____________________ Where do you work: ____________________________ How long at current job: ______ What is your work schedule (days/hours per week): ______________________________ Where will the dog stay when you are at work: __________________________________ Where/who will be responsible for the dog when you are on vacation: _______________ Number of children in the home: ___________ Ages: __________ Family Interests/Hobbies: __________________________________________________ Current pets in the home: ___________________________________________________ Their ages: ______________________ Breed: __________________________________ Pets you have owned in the past: _____________________________________________ Reason they are no longer with you: __________________________________________ Age of death: _____ Have you ever euthanized a pet: _____ Explain: _________________________________ Have you had Berners in the past: _____ Where did the Berners come from: ___________________________________________ Please provide us with your Veterinarian's information: Name: __________________________________ Address: ________________________________________________________________ Phone Number: ______________________ How long with this practice: _______________________ Other Vets: ______________________________________________________________ Why have you chosen this breed: ____________________________________________ Other breeds your have looked into: __________________________________________ Are you interested in a Male: _____ Female: _____ No Preference: _____ Explain your preference: ___________________________________________________ Are markings important to you: _____ Explain: _________________________________ Your preferences are: Dark/Little White: __ Moderate White: __ Large Amt of White: __ Are you aware of the health issues that are related to this breed: ____________________ Explain:
Are you willing to carry out important health certifications and supply us with the results of these certifications:
Do you have any concerns regarding spaying/neutering your pet: _____ Explain: ________________________________________________________________ Do you have any issues with providing us with updates on your pet's progress or setbacks: _____________ Do you have any concerns about our involvement with you and your pet: ____________________________________________________________ Have you read resource books on the Bernese Mountain Dog breed: _____ Which: _________________________________________________________________ Are you interested in learning more about the breed: _____ What training methods are you familiar with: _________________________________________________________ How will you socialize your Bernese
Dog Activities that interest you (Please circle all that apply) Companionship/Family Pet, Conformation, Drafting, Agility, Obedience, Rally/Obedience, Therapy Work, Canine Good Citizen , What types of activities do you enjoy doing with your dog:
What types of personality traits would be undesirable to you in a Bernese:
What is important to you in a breeder / Please explain:
Please attach any information you feel relevant. Thank you for sharing yourselves with us. Thank you for understanding the important job of connecting each puppy’s special personality with the individual needs of each prospective puppy family. We look forward to meeting you. Blue Sky Berners Dave & Shirley Norris 15 W. Owens Rd Deer Park, WA99006 509-276-5369 Blueskyberners@wildblue.net
