Von Wertz Rottweilers
Questionnaire for Prospective Puppy/Dog Owners

*Your Name


*Your Street Address


*Your City, State, and Zip


*Your E-Mail Address


*Phone Number



How did you find us? (Referral from another buyer, internet search, Breeder Directory, etc.)


What sex are you interested in?
Male Female Male, Would Consider Female Female, Would Consider Male No Preference

When were you planning on getting a puppy?


For what purpose(s) are you interested in a Rottweiler?
Family Pet Conformation Obedience Herding Agility Breeding


Are you currently on the waiting list for any other litters?
Yes No

Are you prepared to care of a dog for its entire lifetime?  The average lifespan of a Rottweiler is 10 years.
Yes No Not Sure

Do you have children under the age of 7?
Yes No

If yes, please list the ages of your children.


Do you feel your children respect dogs and other animals?
Yes No

Do you live in:
Single-Family Residence Apartment Townhome Other

Do you rent or own your residence?
Rent Own

Do you have a fenced yard?
Yes No

If not, how will you provide security for your puppy when its outside or when you're away?:


Is there someone home during the day, or able to get home to "potty" a puppy?
Yes  No

Where will this puppy spend the day?
Inside, with breaks to go outside Inside, in a crate Inside, loose Outside, in the yard Outside, with breaks to come in Outside, in a dog run In the garage


Where will this puppy spend the evening?
Inside, with breaks to go outside Inside, in a crate Inside, loose Outside, in the yard Outside, in a dog run Outside, with breaks to come in In the garage


Where will this puppy sleep?
Inside, in a crate Inside, loose Inside, with breaks to go outside Outside, in the yard Outside, in a dog run Outside, with breaks to come in In the garage

Are you willing to attend group obedience training classes with this dog?
Yes No

Have you ever owned a Rottweiler before?
Yes No

If you haven't owned a Rottweiler before, what other breed of dog have you owned, if any? 


Do you still own the dog(s) mentioned above?
Yes No

If not, what happened to the dog(s)?



Please list all pets currently in your household:


Who will have primary responsibility for the care of this puppy?


Do all family members agree on the addition of a Rottweiler to the family?
Yes No

If not, who is not in favor of getting a Rottweiler and why?


Please give us the name, address, and phone number of your vet (or one that has worked with you in the past):


Do you mind if we contact them for a reference?
Yes No

Have you ever given up a dog to a shelter or pound?
Yes No

If so, why?


What type of personality are you looking for in your dog?


Please give us any other information you think will help us get to know you and your needs with respect to placing a puppy most suited to your family/lifestyle: