Name *

First Name

Last Name

Phone Number

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Instagram Handle

This helps me to keep track of who I have previously spoken to though instagram. If you do not have an instagram just leave blank.

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Which are you applying for?

To adopt a puppy

Become a Guardian

Do you live in an Apartment/Condo or a house?

Apartment/Condo

House

Do you have a fenced Yard?

Yes

No

Will in the future

Gender Preference

Male

Female

Open to either

Are you getting a puppy to be a ...

Family Pet/Companion

Service Dog

Emotional Support Animal

Do you have any other pets?

No

Yes

Do you have children?

No

Yes

Will this be your first dog?

Yes

No

Will there be someone home with the puppy all day?

Yes

No

Allergies

Does anyone in the family deal with allergies towards dogs?

yes

No allergies

I understand that there is a Spay/Neuter contract. I understand that if I get a puppy from Pedersen Doodles that it is sold as a pet only! *

Yes

No

I understand that my deposit is non-refundable but that it goes toward the final purchase price of the puppy?

I understand and agree