Please fill out the online form below.

Alternatively you can download the PDF file by clicking on the PDF logo to the left.
Then fill out the form, save it and email it to: 
How did you hear about BellaCane Dobermans?

Personal Info

Phone Numbers:

Are you?

How many children live in your home or visit often and what are their ages?

Does anyone in your home have pet allergies?

If yes, please explain:

What type of home do you live in?

If Other please specify:

If renting, please your Landlords information:

Are there any bylaws, covenants, or other restrictions on dogs where you live?

If Yes please explain:
Does your homeowner or renter insurance company have any restrictions concerning owning a Doberman?


If less than 1 year, where did you live before, and for how long?

Are you planning a move in the near future?


Are you or your spouse active duty military?

Are you

If Other please explain:
Please provide your Employers infomation:

Please provide the Names and Phone Numbers of three non-relative adults who do not reside in the same household as you:

If you have an established Veterinarian, please list name and phone number:

Have you ever owned a Doberman before?

If Yes, please give details:
Have you ever owned a dog other than a Doberman?
If Yes, please give details:
Did your previous dog(s) live their entire life with you?

If No, please explain:

What color do you prefer?

What gender do you prefer and why?

Please explain:
Are you looking for any specific personality traits?

If Yes, which ones and why?
Are you planning on participating in any activities with your dogs?
(please indicate any that apply)
Rally Obedience
Therapy Dog
Dock Diving
Home/Pet Companion
Companion for other Pets
Companion for Children
Have you ever earned AKC or other titles on a dog?

If Yes, please explain:
Where and with whom will your Doberman be in the following situations?

Do you own a crate?

Do you have any objections to crate training?

Do you have a fenced yard?

If Yes, do the gates have locks or latches?

If Yes, please describe:

Would you be willing to allow us to visit your home or if you are out of the area, someone we know do a home visit?

Any BellaCane Dobermans sold as “Pet or Companion Quality” are sold on a limited registration (non-breeding) and are required to be spayed/or neutered after a specified age agreed upon by breeder/owner. Are you agreeable to this?

Do you agree to return your Doberman to us in the event that you are unable to keep the dog for any reason?

Do you agree to keep in contact with us, Tommy and Melinda Moyer, throughout the life of the dog?