Name:________________________________________________________________________________
Phone Number: (optional)_________________________________________________________________________
Email Address:__________________________________________________________________________
*Leesburg Chinchillas is located in Virginia. Can you pick your chinchilla up from here? If not, please let us know, we may be able to meet somewhere.*
Name of chinchilla you wish to purchase: ____________________________________________________
Sex:__________________________________________________________________________________
Color: ________________________________________________________________________________
Age: _________________________________________________________________________________
Price: _________________________________________________________________________________
Why do you want a chinchilla?_____________________________________________________________
Do/Have you owned chinchillas before? ______________________________________________________________________________________
If you no longer have the chinchilla, please state why (leave blank if this is your first chin) ____________________________________________________________________________________________________________________________________________________________________________
Have you ever surrendered an animal to a shelter or rescue? ____________________________________________________________________________________________________________________________________________________________________________
Are you interested in breeding this animal? ____________________________________________________________________________________________________________________________________________________________________________
Do you have a chin knowledgeable vet on hand? ____________________________________________________________________________________________________________________________________________________________________________
Vets Name, Address and Phone Number: ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Do you have a 24 hour chin knowledgeable vet on hand?_________________________________________________________________
24 hour chin knowledgeable vets address and phone number_____________________________________________________________________________________________________________________________________________________________________________
Are you able to take this chin to the vet when needed? Are you able to spend the needed amount of money for vet care?______________________________________________________________________________________
What kind of cage do you plan on using? Do you need us to recommend one? (Please describe the layout of the cage (any shelves? plastic or wooden? ect...)______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
What kind of bedding do you plan on using? __________________________________________________________
What kind of food are you going to use? Do you need us to recommend one? ____________________________________________________________________________________________________________________________________________________________________________
Will the chinchilla have any out of cage time? ____________________________________________________________________________________________________________________________________________________________________________
Do you have any other pets that would bother the chinchilla? If so, how will this be prevented? ____________________________________________________________________________________________________________________________________________________________________________
Have you read the "sales agreement" and do you agree to it?*Please Note: This form must be submitted BEFORE picking up your chin. If I feel you are not ready for a chinchilla, we can work with you. I have the right to refuse any sale. Always do research before buying any animal. *
