Westerners Goldens Puppy Questionnaire

Westerners Goldens Puppy Questionnaire

Prospective Golden Retriever puppy owner questionnaire. Please answer the questions as completely as possible.
Applicant and Household Information
Full Name

First NameLast Name
Street Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
How Did You Hear About Us?
Occupation
Work Days and Hours
Spouse's Name

First NameLast Name
Spouse's Occupation
Children's Names and Ages
Puppy Preferences and Family Readiness
Why do you want a Golden Retriever?
Preferred puppy sex
Please explain your preferred puppy sex
Would you be willing to consider the opposite sex, a different color, or another litter?
What are you looking for in a puppy or dog?
Are you and your family ready for a puppy? Please describe anyone in the home with dog allergies and who is affected.
Housing, Yard, and Current Pets
Housing type
Do you own or rent?

Other
Is there a homeowners' association or similar community rule set?
If applicable, what is the dog permission limit set by your HOA or community?
Describe your yard, including whether it is fenced, fence type, fence height, yard size, and pool fencing if a pool is present.
List any other pets in the home, including species, sex, and age.
Lifestyle and Care Commitments
Anticipated major life changes in the next 2 years

Other
Commitment to provide lifelong care for this dog
Have you previously owned a Golden Retriever?
Which breed characteristics are you familiar with?

Other
Daytime care plan
Nighttime care plan
How many hours per day will the dog typically be alone?
If the dog will be alone for long periods, will you arrange care?
Planned approach to crate training
Expected grooming frequency
Will you feed a premium-quality dog food?
Will you provide routine and emergency veterinary care?
How will you keep the dog safe during severe weather?

Other
Please confirm your care and safety commitments
Additional details about care, grooming, training, or safety plans
Spay/Neuter, Breeding, and Breeder Agreements
Do you agree to spay/neuter the puppy by the breeder’s required age?
Spay/Neuter certificate or veterinary proof number
Do you plan to show or pursue breeding titles with this dog?

Other
If you can no longer keep the dog, do you agree to return it to the breeder?
May the breeder help place the dog in a new home if needed?
Do you agree to receive periodic updates from the breeder?

Other
Truthfulness agreement
References
Reference 1 Name

First NameLast Name
Reference 1 Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Reference 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference 2 Name

First NameLast Name
Reference 2 Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Reference 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference 3 Name

First NameLast Name
Reference 3 Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Reference 3 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Should be Empty:

Westerners Goldens Puppy Questionnaire

Applicant and Household Information

Puppy Preferences and Family Readiness

Housing, Yard, and Current Pets

Lifestyle and Care Commitments

Spay/Neuter, Breeding, and Breeder Agreements

References