Golden Retriever Contact Form

 **Use Microsoft Internet Explorer or Safari or Google Chrome for a trouble free experience

(Using I-PHONE mobile browsers may not be compatible) However, Safari Browser for PC's, Google Chrome and Microsoft IE8  are still the best Browser in my opinion


What sex are you interested in?

Male Female  Either
 
How long are you willing to wait for a healthy puppy to be born from one of our Dam's:
 
 Pepper and Maximus will be bred in October --2014   Boo-Boo Our Current English Cream Male Puppy Fluffy and Maximus 2015    Myra and Maximus 2015 
 
  I am NOT willing to plan ahead for a Proprietarily bred Holistic Golden and learn what it takes to prevent cancer as well as disease from a specialized breeder.  (Currently, cancer among ALL DOG BREEDS is at National rate of 62 to73% between 3 and 10 y/o)

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 amd spouse    Applicant First Name    Spouse First  
Name last     Applicant last name      Spouse last  
                                                                                                    

                                                 Your E-mail (Applicant)

    

    Primary caregivers e-mail  
Tel-Home  
Cell Phone and work Number of Applicant

Work number

 

 

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 raised a puppy in the past?       

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

How many Dogs do you currently own?                      If none write none

 Sex

   Age                                                                                                                                                                          

  Breed

Is he or she Neutered or Spayed?                                                     

What Brand Dog Food do you or did you feed your Dog?                                 

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?   Husband what kind of business?)                                                                                                                    Wife What Kind Of Business                                                                                                                                                                                                                                                                                                              
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 to extend his/her lifespan ?                  
 
PLEASE TURN OFF YOUR POP-UP BLOCKER BEFORE YOU HIT SUBMIT

 

Home Page

Copyright © 2014 All rights reserved.
 

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.