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
Allergies in the family?
Looking for male or female?
Questions or Comments:

AFTER I talk to you please take the time to fill out this
form so I have all the information about you in one place
for the microchips and registration papers.

If for any reason this questionnaire doesn't
work please include the information asked
for in an email