Madame Glitters Puppy Palace

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I will pick up my Puppy:
Please ship my puppy:
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Airport Choice 1:
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I want a puppy already born:
Enter the puppies name:
I want a future puppy:
Desired Litter:
Desired sex of puppy: Male Female
Desired colors:
Notify me when puppy born by: Phone E Mail
Do you live alone: Yes No
Adults only in the home: Yes No
Any children in the home: Yes No
If so how many:
If so what ages:
Previously owned a Shih Tzu: Yes No
Has your pet recently died: Yes No
If so what was the cause:
Have you owned dogs before: Yes No
Were they kennel trained: Yes No
How many hrs a day kenneled:
What other breeds have you had:
Any other pets in the home: Yes No
If so how many:
If so what kinds:
Do you have a fenced yard: Yes No
Other secure outdoor area: Yes No
If so describe it:
Live in House or Apartment: House Apartment
Are you retired: Yes No
Anyone home during the day: Yes No
If not where will dog be kept:
Will you house train: Yes No
Will you use puppy pad: Yes No
Aware of grooming needs: Yes No
Do you have a Vet: Yes No
Can we contact the Vet: Yes No
If so Vets Phone Number:
Aware of costs of Vet bills: Yes No
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Madame Glitters Puppy Palace
Contact: Diana
diana@madameglitterspuppypalace.com
Home Phone: 785-484-2972
Cell. Phone: 785-224-7901
Kansas Animal Health Retail Breeders License # RB-934-2007

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This website was last updated on 05/16/2008 4:52 AM

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