Golden Retriever Puppy Questionnaire

GOLDEN RETRIEVER PUPPY/ADULT QUESTIONNAIRE

> If you are submitting a questionnaire for a PUPPY, please answer all questions.
> If you are submitting a questionnaire for an ADULT, please answer questions with a  *  before the question.

> NOTE:  Please put an  "X"  AFTER any available choices.

*DATE:

*LITTER or Name of Adult:

> If puppy is to be owned by more than one person, for registration, one has to be the owner and one the co-owner.

*OWNER:

*CO-OWNER:

*PHYSICAL ADDRESS:

*MAILING ADDRESS (if different):

*E-MAIL ADDRESS:

*HOME PHONE #                       *Best time to call you:

*WORK/CELL PHONE #:

SEX PREFERRED:  Male ___    Female ___   Will take the opposite sex ___   No Preference ___

PURPOSE  -  Show     Companion     Other - Please explain:

* Where did you hear about us?

We kindly ask that you reply to the following questions.  These questions are not meant to be judgemental in any way.  The more information we have, the more able we will be to have some insight into your lifestyle and expectations.  Please feel free to add any additional comments at the end.  Completion of this quesitonnaire is in no way a guarantee that a puppy/adult will be available for you.  Puppies' personalities are matched with each buyer's lifestyle, along with what the buyer has communicated that are looking for in a puppy, with the temerament testing being the final determining factor.

*  Number of adults living in your home::
  *  Number of children living in your home including ages:

*  Is anyone in your home afraid of dogs?        Yes     No
     If yes, please explain:

*  Does anyone in your family suffer from allergies?     Yes     No

*  Are all members of your household away during the day?     Yes     No
  *  If "Yes", how many hours in an average day would the puppy/adult be alone and will you     
     make arrangements for someone to come in to feed and potty the puppy/adult?

*  Do you own or rent your home?     Own     Rent
     Renters must have a letter of permission from their landlord before a puppy can be taken.

*  Do you have a fenced yard?     Yes     No
  *  What kind of fence?
  * If you do not have a fence, how will you exercise your puppy and will your puppy/adult be      
     outside unsupervised?

*  Have you owned a dog before?     Yes     No
  *  If you have, what breed/type and what happened to them?

*  Do you currently have any pets?     Yes     No
  *  If yes, please list type and ages:
  *  Will they adapt well to adding another animal to the family?

*  Why do you want a Golden Retriever puppy/adult?

*  Does everyone in your household want a puppy/adult?     Yes     No

Have you ever raised a puppy?     Yes     No
     If "Yes" what breed?

Are you willing to take your puppy to classes for help with training?     Yes     No

Does everyone in your household understand puppy behavior?     Yes     No

Important:  Puppies will jump on you, knock down young children, will bite during teething, and can grab clothing, causing strangulation of a child, therefore, should never left loose with young children.  All interaction with children throughout the puppy's life should be closely  supervised.  Puppies must be taught acceptable behavior through proper training which is done with love, not force.  this can be accomplished through puppy and advanced classes or indiviidual instruction.

*  Do you agree to contact Acadia Golden Retrievers for assistance in placing your Golden,
     if at any time you are unable to keep your puppy/adult, for whatever the reason?    Yes     No

*  Have you ever returned a puppy/adult to a breeder?     Yes     No          
     If yes, please explain:

*  Have you put a deposit with anyone else at this time?     Yes     No          
     If yes, who?

*  Do you understand that Goldens thrive on human attention and cannot be isolated, which will 
     require a huge time committment from you?    Yes     No

*  Are you willing to share your home with a Golden Retriever and not make him/her a dog who lives 
     outside the majority of the time?     Yes     No

*  Where will your puppy/adult sleep at night?        Inside        Outside

Do you plan on using a crate to help house train your puppy?     Yes     No
     If not, how do you plan on housetraining?

*  Will an adult be responsible for the feeding, grooming (Goldens shed quite a bit), and    
     training of your puppy/adult?

*  To help you choose a puppy/adult who will be compatible,  briefly tell us about your family's    
     lifestyle, hobbies, and interests:

*  Briefly tell us about the attributes you would like your puppy/adult to possess:

*  The health of our puppies/adults is very important to us.  Are you willing to continue our     
     efforts and follow the recommendations which will be provided in the contract and Puppy Pack, 
     concerning diet/supplementation, avoiding excess weight, monitoring exercise, spay/neutering 
     ages, and minimal vaccination?       Yes     No

*  Are you prepared to care for your puppy/adult for 10+ years and willing to invest in veterinary 
     costs in the event of health problems?     Yes     No

Once puppy visits start, will you be able to visit?     Yes     No

Can your name and e-mail address be given as a puppy reference?     Yes     No

REFERENCES

*Veterinary reference:
If you do not have a vet, who do you plan on using?

*Other reference:

NOTE:  ALL PUPPIES GOING TO COMPANION HOMES ARE SOLD ON LIMITED REGISTRATION.  Limited registration means that your puppy is registered with AKC but no litters produced by this puppy are eligible for registration.  This is recommended by AKC and helps protect breeding programs.  Dogs with Limited Registrations can compete in various AKC events exculding conformation.  If a puppy buyer later decides he/she wishes to show the puppy at conformation events, the puppy can be re-evaluated by the breeder and if found to be show quality, the limited registration can be changed, by the breeder only, to a full registration and the sales contract can be amended to include the terms of our show contract.

RESERVATION DEPOSITS:  If you would like to purchase a puppy from Acadia Golden Retrievers and are willing to give one of our puppies a forever home and treat him/her properly, with gentle, loving guidance as a treasured companion, we ask for a $200 good faith deposit once the pregnancy has been confirmed, which will be deducted from the total price of the puppy.  Deposits are 100% refundable - please see the "About Us & Reserving A Puppy" page for refund info.  Approved homes who have reservation deposits, will receive a Puppy Packet, which contains various info on diet, exercise, training, vaccination, etc, and will also receive e-mails with puppy pictures and weekly development updates.  Puppies will be held only with a deposit.

Please make all checks payable to "Patti Covert" and mail to:

Acadia Golden Retrievers
c/o Patti Covert
P.O. Box 301
Lemon Springs, NC   28355

Thank you for taking the time to complete our questionnaire.

I will contact you  confirming that I received your completed questionnaire and answer any questions you may have.  Looking forward to talking with you!
If you do not hear from me, please e-mail to confirm that I received your questionnaire.