PhogHaven Cane Corso

Full Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Are you at least 18 years of age and able to enter a legal agreement? *

Yes

No

Do you have children in your home or as frequent visitors? *

Yes

No

What would you consider your lifestyle to be? *

Sedentary

Mildly active

Moderately active

Highly active

Does anyone in your household have pet allergies? *

Yes

No

Unsure / Don't Know

Do you own or rent? *

Own

Rent

Other / Neither

What type of residence? *

Apartment

Duplex/Townhouse

Single Family Home

Farm/Acerage

Other

Do you have a fenced yard? *

Yes - fully fenced

Yes - partially fenced

No

Have you ever owned a guardian breed? *

Yes

No

Will your new dog live inside or outside? *

Primarily Inside

Primarily Outside

How many hours a day will the dog be left alone? *

0-4 hours

5-9 hours

10+ hours

Current Veterinarian *

First Name

Last Name

Veterinarian's Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Veterinarian's Phone Number *

(###)

###

####

Do you agree to let us contact your veterinarian at any time regarding the health of your new dog? *

Yes

No

Have you ever had a litter of puppies before? *

Yes

No

I am interested in: (select all that apply) *

Pet / Companion Animal

Conformation / Showing

Protection / Working

Performance / Sporting

Breeding

I would prefer: (sex and/or color) *

Please select as few or many as applicable.

Male

Female

Black

Black Brindle

Fawn / Red Fawn

Blue (Grey)

Blue Brindle

Formentino

Rare / Unusual color

No preference

Will you commit to getting your dog obedience trained by 12 months of age? *

Yes

No

Will you commit to getting your dog a wellness checkup by a licensed veterinarian at least once a year? *

Yes

No

Are you willing to use preventative medication (flea/tick/heartworm) for your dog? *

Yes

No

Are you willing to get x-rays and provide us with PennHip/OFA scores at 24 months of age? *

Yes

No

Do you agree to return the dog to us if for any reason you are unable to keep the dog? *

Yes

No

I have read and understand the "must read" page on the PHCC website. *

I agree

I do not agree