• Claircrest Golden Retrievers

  • Nickie Hertzog
    Email: Claircrest@aol.com

  • ADOPTION APPLICATION

  •  - -
  • Gender*
  • I wish to adopt a:*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Please answer the questions below and provide a brief explanation, if necessary:
  • Marital Status*
  • Does your spouse also want a dog?
  • Do you have children?*
  • Have you ever owned a dog(s) before?*
  • Have you ever owned a dog(s), and decided you either did not want or could not keep the dog(s) anymore?*
  • Have you ever returned a dog(s) to a breeder?*
  • Vaccines and/or titers always up-to-date?*
  • Checked for worms?*

  • ADOPTION APPLICATION continued...

  • Is/Was your dog on heartworm preventative?*
  • Have you ever taken your dog(s) to obedience class?*
  • Have you read any books on Golden Retrievers and/or dogs?*
  • Do you have a fenced yard?*
  • If no, do you plan to fence soon?*
  • Do you plan to maintain vaccines?*
  • Do you plan to groom and/or bathe this dog?*
  • How often?*
  • Who will groom/bathe the dog?*
  • Do you know how to trim nails?*
  • How often?*
  • Do you plan on training your dog?*
  • Do you plan on showing your dog?*
  • *
  • *
  • Will you train the dog yourself?*

  • ADOPTION APPLICATION continued...

  • Do you plan to breed your dog?*
  • Do you plan to spay or neuter your dog?*
  • Are you aware of what the following can cost?*
    • Good quality food
    • Toys
    • leads and collars
    • dog house and crate
    • food and water bowls
    • training expenses
    • veterinarian bills (i.e. shots, office calls, worm checks, heartworm medication, skin problems, pulled muscles, x-rays for hip dysplasia, eyes checked for cataracts, ear infections, periodic blood samples, surgery, veterinary specialist evaluations, testing, and other health care cost for a variety of issues)
  • Would these expenses be difficult for you to pay?*
  • Are you willing to pay for these expenses when and if needed?*
  • Can you spend adequate time to raise a puppy, train it, and play with it?*


  • I am or someone in my family is home most of the time every day.
    B. I/We work or go to school part-time, but someone is home a good portion of the day.
    C. I/We work an eight-hour day, but someone is home most every night and weekend.
    D. I/We work eight hours or more a day, and I am and/or we are gone lots of evenings and/or weekends with different activities.
    E. I/We have our own business in our home.
    F. I/We am/are able to take the dog to work.

  • Would you be interest in joining a local club pertaining to dogs and/or Golden Retrievers?*
  • Would you mind if the breeder took future interest in the pup/dog looks, health, training, etc.?*
  • Is there any certain time of the year that you prefer to buy or not buy a puppy?*
  •  - -
  •  - -
  • Please feel free to call and make an appointment to visit Claircrest on a Friday afternoon or early evening that we are not going to a dog show! All adoptions are within the State of Missouri legal jurisdiction.
  •  
  • Should be Empty: