Thank you for your interest in one of our precious Cockapoo puppies.  We screen all of our new families and require the questionnaire be completed to be on the waiting list.  Once this is done, we ask for a $400.00 deposit, in the form of a Money order or Paypal payment.

Deposits are non-refundable and will be applied to the total purchase price of your puppy.  

The remaining balance is due when your puppy is 6 weeks old.

Once we receive your Questionnaire form, we will contact you within 48 hours to discuss it and provide details about our current puppies and upcoming litters.

Some families have had problems submitting this Questionnaire.
If you can't submit this just send me an email with the information or call. 
regalcockapoos@yahoo.com   or   563-340-4354

The Puppy questionnaire is below!  
Please Submit your response at the bottom of page

Please remember to fill in your Name, address, Phone number and Email Address in this first Box!!!!  


Name: 

Address: 
City: State: 
Zip:
Home Phone : 
Cell : 
Email Address:


Please tell me the best way to reach you:  
Home Phone, cell Phone, or email





1.  How did you find us?  Referral, Internet, What website.









2. Do you prefer: MALE or FEMALE? Please explain why:









3. What color do you prefer?  What Size do you prefer (lbs.)?







4. Do you want to reserve a puppy from a specific litter? 





 If yes, which one: 



5. Does everyone in your family want a new puppy? 





6. Does anyone in your family suffer with allergies? 




    If yes, how severe? 




7. Do you have children? 
    If Yes, please provide their ages:








8. Do you currently own a dog? 
    Age and Sex:   
    Breed:   
    Is he/she Spayed or Neutered?:







9. Do you have any other pets? 
      What Types: 





10. Do you have a fenced in yard? 







11.  Will you continue the crate training we have started? 






12. Are you aware of the time and energy needed to care for a young             puppy and willing and able to accept that responsibility? 




13. Do you have the means to budget the cost of a new puppy? (Puppy         shots, monthly heartworm medication, annual vaccinations, crate,            bedding, food, toys, grooming products, etc.)? 





14. Are you committed to caring for this puppy for it's lifetime (15                    years)? 




15. Are you willing to attend obedience classes with your puppy if needed?  





16. At Regal Cockapoos, we require the puppy/dog be returned to us - at       any age - if you are unable to care for the dog. We never want one of       our puppies/dogs to end up in a shelter or somewhere he/she's not          wanted.  We will work with families if you have the perfect home but        we want to know if the dog has been re-homed. 

     Do you agree to notify Regal Cockapoos first if you can no longer             keep your cockapoo?   





17. Most of Regal Cockapoo puppies are sold on a strict NON-BREEDING       - Spay/Neuter Contract.  We DO NOT allow our pet puppies to be              used for breeding.  
     Do you agree to spay/neuter your puppy by 9 months of age? 









I have answered all of the above questions truthfully. I understand that if any intentionally false answers have been given, Regal cockapoos reserves the right not to sell to me.  By signing below, I agree to the re-home and spay/neuter policy as explained above and on the Health Warranty/Contract.  






Remember to hit Submit!!!  
If you Don't here from me within 2 days please call or email.










Regal Cockapoos Puppy 
Questionnaire

Puppy Depsot and Payments