Microchip Information Form Name(Required) First Last Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Email(Required) How did you hear about us?(Required)Please ChooseGoogleFacebookInstagramFriend / ReferralCommercialEmployee Follow upOtherHow did you hear other(Required)Congratulations on the purchase of your adorable Furrylicious Puppy! Please be advised of our policy when a puppy is purchased but is not going home with you right away. The puppy purchase is considered a FINAL SALE, with the exception of a health issue that would prevent it from going home when ready. This is due to the considerable time, effort and expense undertaken by our staff, as well as because the puppy is taken off the website, sales floor and all other advertising by Furrylicious. Therefore, other opportunities to place the puppy are lost. Please make sure you are confident in your decision to purchase this puppy and understand he/she is FINAL SALE even though he/she is not going home with you today. No exceptions will be made for change of mind, change of circumstance, allergies, landlord or housing issue, family matters or any other issue unrelated to the health of the puppy. By signing below, you understand this policy. Date(Required) Month Day Year Signature(Required)
