Golden Retriever Contact Form  

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What sex are you interested in?

Male Female  Either
 
How long are you willing to wait for a puppy to TAKE HOME from one of our Dam's: Bebe or Fluffy or Woofy?
 
6 months   1-year   Longer If  Necessary       I am NOT willing to plan ahead for a holistically bred Golden and learn what it takes to prevent cancer and disease

Which upcoming litter are you interested in (use up/down arrow to scroll)

<<<<-- Use this up/down arrow to choose Dam and Sire

Enter your comments or questions in the space provided below. Please keep it short and to the point.

 

Tell us how to get in touch with you: Please fill out completely.

Name First of Applicant and Spouse                                     Spouse                                               
Name last                  Spouse last name                                
Email                                                                                                         Your E-mail                                                                        <-Spouse's e-mail address
Tel-Home   Do not use parentheses
Cell Phone  
Street and City where your Golden will reside Full Time-- include house number  House number and Street        City 
State  
zip  
How did you find this site?   
Are you interested in breeding or pet?  
Is this puppy for you or someone else?  
On a scale from 1 to 10 what is your interest level to own a Golden   (10 being the highest)
At any given time, how many hours will your Golden Retriever be alone without human contact?        Please Be Specific   (enter a number)     
Where will puppy live, Condo. Apartment, House, Outside?    

What percentage of the time will your Golden be outside alone?                                              

How many Children do you have and what are their ages and sex?  
Do you own or Rent?  

In which room of your house will your puppy sleep when you go to bed?     (Be specific)   

How many years at present location?  

Have you ever personally owned a puppy in the past?                        

How many years did you own him/her?  (enter a number)                   

How many Dogs do you currently own?                                                                                                                                              Sex                                                                                                                Age     Breed
Is he or she Neutered or Spayed?                                                    
Does anyone in your home have any allergies?                        
Does the primary caregiver have any disabilities, mental or physical or diseases that would interfere with him/her from caring for the puppy? If so , please explain briefly.                     
Occupation? (If business, what kind of business?) Husband and Wife       Husband                                                                                                                                                                                                         Wife
Who will be the primary caregiver for your puppy?                      

What kind of fence do you have to contain your golden when he/she runs out the door?                              

           Are you interested in learning how to protect your Puppy/Adult against Allergies, Diseases and Cancer throughout it's life and extend his/her lifespan ?                  
 
 
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The information you provide will be kept on  file privately by me for the sole purpose of answering questions or contacting you when upcoming puppy litters are due and never sold or distributed to any other person or organization.