Name
*
Email Address
*
Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Phone
Occupation
How did you learn about us?
Why have you decided to buy a Golden Retriever?
Do you Prefer a male or female
Male
Female
If your choice isnt available
Do you have children
How old are they
Do any family members have allergies to dogs?
Have you ever put a dog to sleep?
Yes
No
Why
Do you own your home?
Yes
No
Do you live in a house or apartment?
Yes
No
Where will the puppy be during the day?
Will someone be able to potty the puppy?
Yes
No
Do you have a fenced yard?
Yes
No
Do you have a chain link kennel run?
Yes
No
Have you ever had a puppy?
Yes
No
If so, what breed?
Who will train this puppy?
Have you ever crate trained a puppy?
Yes
No
If "no" why not?
Have you ever completed an AKC title?
Yes
No
If yes, what titles have your dogs earned?
What personality do you want in a puppy?
Additional information to help us pick your puppy?
How much do you expect to pay for a puppy?
Will your puppy live primarily in the house
Yes
No
Do you currently have any other pets?
Yes
No
If so please list.
Do you agree to have your puppy spayed/neutered?:
Yes
No
Are you willing to obedience train your puppy?
Yes
No
Please list three references including your vet
Other information you would like to share
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