Information we would like about You.
Your name:
Your email address:
Your phone number:
Your Address:
Emergency Contact Person:
Emergency Contacts phone:
Other pets in the home:
Ages of those in the home:
Current Vet:
How you found Chai
Kennels:
Allergies in the family?
Looking for male or female?
Questions or Comments:

If Interested in a pup please fill our this questionnaire and
make an appointment to come visit with us.

Thank-You!
If for any reason this questionnaire doesn't
work please include the information asked
for in an email
lisa@chaikennels.com