As a breeder, I have responsibilities that include:

1. Limited breeding of healthy dogs of sound temperament.
2. Breeding with the goal of improving the Chow Chow breed.
3. Placing my puppies in responsible homes and doing my best to prevent unwanted dogs from going to the shelters or living in an abusive environment.

One way in which I facilitate the above is to ask my potential puppy families to answer this questionnaire. Thank you for your assistance!

1. Why are you considering a Chow Chow?

________________________________________________________________________________ ________________________________________________________________________________

________________________________________________________________________________

2. Have you ever had a Chow Chow?_____ Do you know much about Chows? (health problems, life span, special needs) _______________________________________________________________________________

________________________________________________________________________________

3. Are you looking for a male or female?_______________________________________________________

Why?_______________________________________________________________________________

4. Are you looking for a pet or are you planning to show?________________________________________________________________________________

5. If you are interested in a show dog, have you attended any dog shows?______________________________

Are you aware of the costs and time involved in showing dogs?______________________________________

6. Are you interested in breeding your dog?____________________________________________________

7. Do you have any other pets?_____________________________________________________________

Have you had any pets in the past and what happened to them?_______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

8. Do you have any children?_____________________________________________

What are their ages?_____________________________________________________________________

9. Do you live in a house or an apartment?_________ Do you rent?_____________

If so, does your landlord have any objections or concerns about you having a dog?__________________________________________________________________________

Do you have a fenced yard?________________________________________________________________

What type of fence is it and how tall? _________________________________________________________

10. Where will your dog stay?______________________________________________________________

How about while you're at work?____________________________________________________________

While you're asleep?______________________________________________________________________

11. What type of dog food will you feed?______________________________________________________

Are you familiar with the health problems created by feeding "grocery store" food?_______________________

12. Are you familiar with crate training?_______________________________________________________

13. If you are interested in a pet puppy, do you have an objection to spaying or neutering your dog?__________________________________________________________________________

14. Would you have an objection to signing an agreement that in the future, if for any reason you do not want or can not keep this dog, that it will be signed back over to the breeder?_____________________________________________________________________________

15. Your veterinarians name and phone number._________________________________

16. Can you supply any references? (Name & number, preferably professional) _______________________________________________________________________________

_______________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

Your Name:_________________________

Your Address:___________________________________________________

Your Telephone Number: ______________________

Your email address: __________________________________

Thank you again in helping me to assist you to be sure that my puppy will best meet your needs.

Please complete the above form and mail to me at:

Christine Cameron

15760 Jackpine Road

LaPine, OR 97739

OR you can email it to me at: chowfull@hotmail.com

If you have any questions or concerns, please feel free to contact me at:

chowfull@hotmail.com

Thanks!