Cashmere Puppy Questionnaire

The following questions are being asked of you so that the right puppy and the right placement of each puppy is made by bringing the various requirements of both the puppy and his or her new owner(s) into perspective, BEFORE a choice is made. I hope you will agree that the animal's welfare must be my foremost consideration in considering a placement. Please answer the following questions as completely as you can, and return this form when you've finished

Submission Date:______

Name and Significant other: ______

Address: ______City and Zip code______Phone including Area code______Alternate Phone Number______Email Address______Where did you hear about Cashmere Golden Retrievers: ______

How many members does your family have and what are their ages?

What are your occupations? And hours of work?

When you go on vacation who will care for the puppy /dog while you are away?

Is someone available throughout the day to exercise and potty break the puppy?

If not, how do you plan to exercise and potty your puppy during the day? How many hours do you expect the puppy to remain home alone? Do you own your home, rent, or reside with others?

Do you live in a house, townhouse, apartment, condo, or other?

If you rent, has your landlord agreed in writing to allow you to have an inside dog of this size on the premises?

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Name and phone number of Landlord______Is you residence rural, suburban or in the city?

How long have you lived at your house? ______

Do you have a securely fenced yard? ______

If not, how do you plan to prevent your puppy/dog from roaming or being stolen?

______Do you have a pool? If yes is it fences in?

______Where will the puppy live?

______Who will be the primary care giver of the puppy?

______Does anyone in your family have allergies? If so to what?

Have you ever owned a Golden Retriever before? If yes (for how long, where did you obtain your Golden) What happened to it? If deceased how did he/ she die?

Have you ever owned any other breeds of dog? If so, which breed and what happened to them? And were they AKC registered?

Are there any other dog(s) in your home right now? If so, which breed and what is their approximate age and sex?

______Have you ever given a pet away? If so, what were the circumstances?

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Do you have cats? If so, how many and how are they with your dogs? Where do you place their food?

______Do you have a regular veterinarian? Please list name, address and phone number?

______What are you willing to supply for your puppy? Proper Immunizations ______Heartworm prevention______Flea prevention______Crate______High Quality food______Spay/ Neuter______

Are you willing and able to supply proper immunizations for your puppy? New puppies require immunizations at 6, 9, 12, and 16 weeks of age. Each visit runs approx. $ 95.  Our puppies that are placed in a pet home will come with a Spay/Neuter contract. Are you prepared and willing to have your puppy spayed or neutered at the appropriate age of 6-12 months?  ______

Are there likely to be any major changes in your lifestyle in the near future (such as moving, pregnancy, care of elderly relatives etc)? Explain

______What have you actually inquired about for your new puppy? Veterinarian______Obedience Classes______Breed Specific info______Types of Puppy food available ______Crate Training______Other______

Do you plan to use a crate for your puppy? If no, why not? Then what are your plans? When you considered buying a puppy what were the primary reasons? Check all that apply Gift for someone______Just want a dog______Companion or Therapy Dog______Breeding______Showing______Obedience, Field Agility or Rally______Recent loss of another Furever friend______Other______

If requesting a Show/Performance puppy please briefly summarize your experience.

Which are you primarily interested in? Male______Female______Either (doesn’t matter…will love either)______

Are you willing to accept a puppy of the opposite sex, if your first choice is not available?

______What colors are you primarily interested in? Light Gold______Medium Gold______Dark Golden______Red______

Are you willing to attend at least basic obedience classes? If not, explain

______Are you willing to return the dog to the breeder should some unforeseen circumstance arise and you would no longer be able to keep the dog?

______Which of the following will you be prepared and willing to do for your puppy?

OFA Hips/Elbows x-rayed at 24 months______CERF Eye exam by a Certified Ophthalmologist? ______Heart Auscultated by a Certified Cardiologist for OFA______Provide information /results obtained from the above tests to the breeder of your dog______Please explain in your own words why you have chosen a Golden Retriever as your next puppy

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Please submit any additional information you feel would be important to me as the breeder to feel comfortable sending home one of my little Golden puppies with you______