Puppy Form

All dogs used in our breeding program have had their hips certified through OFA, their eyes cleared-annually by a board certified ophthalmologist and their hearts cleared by a board certified cardiologist.  Our goal is to produce a healthy and structurally correct puppy with a "True Golden Temperament", we personally look to place our puppies into homes where they are going to be in the house and part of the family.  Whether they are being placed as show dogs or as a family companion our goal is to breed the temperament and character that best suits this life style, gentle, friendly and easy going but we also strive for a temperament that will be versatile for the show, obedience and/or field.

Your assistance in completing this questionnaire will help us to place the right puppy in your home.  All information will be kept confidential and used only by us.  Thank you for your cooperation and interest in our dogs.

How did you hear about our dogs?_______________________________________________

Your name:__________________________________________________________________

Home phone# ________________________  email address: __________________________

Home address: (if you use a PO Box for mailing can you please also include your actual street address) ____________________________________________________________________

Occupation's (this is important as it will indicate to us how much time the puppy will be spending at home by it's self): ___________________________________________________

1)  Why have you decided that the Golden Retriever is the breed you wish to own? _________ ____________________________________________________________________________

2)  Have you ever owned a Golden Retriever before or any other breed of dog? If so what breed(s)____________

3)  Are you looking for a young puppy ___________ or an older dog _____________________

4)  Is your preference a male ____ or female ____, light, medium or dark in coat color _______

If your first choice is not available would you be willing to take a puppy of the opposite sex or different color, or would you wait for another litter? __________________________________

5)  What is the most important thing you are looking for in a new puppy/dog? _____________ _____________________________________________________________________________

6)  What is/are the main reasons for purchasing a Golden Retriever (please check all the apply):  family companion ______  Show prospect ______ Breeding ______ Obedience competition ____ Hunting/Field work ____ agility _____ Pet therapy _____ Tracking _______

7)  Are all members of the family ready for a new dog? _______________________________ Will there by any major changes in your life style in the next year?  (example moving, marriage or a new baby?) ______________________________________________________________

8)  Do any members of your family have any type of allergies to dogs? ___________________

9)  Do you live in a house, townhouse, condominium etc. ______________________________

10)  Do you own or rent where you presently reside? ______________  If you rent have you discussed having a dog with your current landlord? ___________________________________

Landlord name and phone number: ________________________________________________

11)  Is your yard completely fenced with a secure fencing? _____________________________ If not, would you be willing to do so before bringing home a new puppy/dog or build a secure run for the puppy/dog to be in when not being safely supervised? _______________________

12)  Do you currently own any other pets? If so please list__________________________________________

13)  Age of children in the home? _________________________________________________

14)  Would someone be home with the dog during the day? ____________________________ Are you willing to crate train your new puppy? _______________________________________ If no one is going to be home during the day when the puppy requires extra attention and feedings, would someone be able to come home to feed the puppy it's lunch and let it out for exercise to keep it on a regular routine? ____________________________________________ _____________________________________________________________________________

15)  Where would the puppy or dog be housed during the day if no one is home? ____________ _____________________________________________________________________________

16)  Are you willing to take this puppy to puppy socialization classes and then on to obedience classes so that it will become an enjoyable companion and good canine citizen? ____________ Who in your home would be doing the training? ______________________________________

17)  Have you ever completed a CKC or AKC title in conformation, obedience, field, tracking or agility? _____ If yes please list ___________________________________________________

18)  Do you agree not to let this dog ride in the back of an open vehicle? _____ Do you agree never to let this puppy/dog run loose in a unfenced area unsupervised where harm may come to it? _______  Do you agree never to tie this dog up as a means of confinement? _______  Do you agree not to use a electric collar on this dog for the purpose of training? __________

19)  Have you ever had to euthanize a puppy or dog other than for old age? If so could you please state the reason ________________ _____________________________________________________________________________

20)  Would you be willing to let the breeder or a friend of the breeders come to visit the puppy or dog once it is in his or hers new home to see how it is working out? _____________ ______

21)  When this puppy is purchased as a family companion and is not going to be bred, do you agree to have it spayed by 6 months if it is a female or neutered no later than 1 1/2  years of age if it is a male and submit a veterinarian certificate to the breeder as proof of surgery for her records? _________________

22)  Are you willing to contact us and keep us informed of any problems that may develop with the pup throughout  it's entire lifetime? _____________  Send us lots pictures? ____________

The following questions (#23 - #28) need to be answered only if this puppy/dog is not going to spayed or neutered and is being sold for the purpose of showing and breeding on a co-ownership:

23)  Do you have any intentions of breeding this dog? ______  What would your reasons be for breeding? ____________________________________________________________________

24)  If you decide to purchase a show quality puppy are you willing to show it or have the breeder show it to his or hers Canadian and/or American championship? __________________  Would there be other titles that you would be interested and willing to put on the puppy/dog? ____________________________________________________________________________

25)  If this puppy is bought for the purpose of showing and/or breeding and it is found not to be of breeding or show quality, would you spay or neuter it upon the request of the breeder? _____________________________________________________________________________

26)  Are you willing to take full responsibility for all puppies produced by this dog? _________  And at anytime if a situation arises that one of the owners of one of the puppies that you have placed or sold from any litter produced by this dog is no longer able to keep and care for it, would you be willing to take it back and find it another suitable home?  ___________________ _____________________________________________________________________________

27)  Are you willing to place all puppies that are being sold as family companions to pet homes on either a CKC non-breeding contract or a AKC limited registration? _________  And any puppies that are being sold that may be bred, will be on a contract, and in the contract have it state that before they are bred that they should be a minimum of 24 months, will have their final OFA clearances (hips and elbows)  and a eye and heart clearances from board certified veterinarians.  That they will be of breeding quality including temperament and that the owner has endeavored to obtain it's championship? ________________________________________

28)  It is our personal policy that if a puppy/dog is being placed in a show and breeding home and it is not going to be spayed or neutered our policy / contract is to place these dogs on a co-ownership.  Would this be a concern to you, and if so please explain your concerns that you would have with a co-ownership? ________________________________________________ ____________________________________________________________________________

If you have anymore additional information that would be helpful; to us, in placing the right puppy or dog with you, please feel free to add it below ________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ 

Thank you for taking the time to fill out this questionnaire to help us in finding the right puppy for you.  Please feel free to call us if you wish more information or need questions answered.

If you think you are interested in adding a new family member now or in the near future, please feel free to print off a copy of this questionnaire, fill it out and mail it back to us or you can copy, cut and paste it into a email.  If you would like to come and visit us and our dogs we would be more than happy to set up an appointment for you.  It will also give us a chance to ask you a few more questions so we know exactly what you are looking for in your new puppy.  When placing our puppies we do not work on a first come first serve basis, we will look at the individual lifestyle of each new potential home and match the best puppy to that home.  We do take your considerations into account when choosing the puppies but the most important thing for us is to place the right puppy into the right home.  We have found over the past 19 years this has been the best way to place the puppies, and hope that the puppy that is chosen for your home is a welcomed addition to your family.

Date: _____________________  Signature: _________________________________________

If we have a current litter with a puppy available, you have decided you are ready for a puppy and the questionnaire is accepted we do ask for a $300.00 deposit, this is the only way to insure that you will be put on the puppy list for that litter.  The deposit is to show us that you are seriously ready to have a new puppy enter your home and have taken the time to think through all the commitments and time that is needed to raise this new addition to your family.  We will not take any deposits until the puppies are at least two weeks of age.  If for some reason beyond our control a puppy is not available then the deposit will be returned.

Your can send this questionnaire to pacificgold@shaw.ca, two ways, either copy and paste it into Microsoft Word or similar program, fill it out and then send it as an attachment in a email  or print it off, fill it out, scan it, save it as a jpg file and send it to me as an attachment that way.  Thank you.

Carol Morrison - Pacificgold Golden Retrievers