Portuguese Water Dog Puppy Request Questionnaire

Please complete and return the following questionnaire. This will assist us in the selection of an appropriate puppy for you and your famiIy.

Contact Information


Household Information

Please enter a number from 1 to 10.
Do you have children?(Required)
(separate each age with comma)
Does every family member want a dog?(Required)
For what purpose are you purchasing a Portuqaese Water Dog? (Check all that apply to you)(Required)