Name:___________________________________ Address_________________________________  City:____________ State:__________ 
Zip Code_________ Preferred Contact  Number:________________________ 
Email Address:_________________________________  
Will you be home with the puppy during the first several weeks to ensure a smooth transition? Please  provide us a brief description on what your daily routine is like.  ___________________________________________________________________________________________________________________________________________________________
If no, please tell us where the puppy will be kept and how long. Also, please provide a description on  what the puppy routine will be on a daily basis.
______________________________________________________________________ 
All following questions must be answered, please circle your answer to the following questions.  
Do you live in an apartment or house? Apartment. House.  
Do you rent? Yes. No. 
If so, does your property owner allow pets? Yes. No.  
Do you have a yard? Yes. No.  If so, is it fenced? Yes. No.  
Is anyone in your household allergic to pets? Yes. No.  
Which will your pet spend most of their time? Indoors, outdoors, or both? 
 Do you currently have a veterinarian that you have used in the past or someone has referred you too? If  so, please list clinic name, preferred doctor and a phone number. ***Banfield vets are excluded from our health guarantee & will void any health guarantee we offer on our puppies if taken there.*** ________________________________________________________________________________Do you have or will purchase an appropriate size crate for your puppy? Yes. No. 
If puppy will not be crate trained please provide information on how they will be trained.  ________________________________________________________________________Have you ever house trained a puppy before? Yes. No.  
Do you plan to teach your puppy obedience or attend classes?  Teach he/she at home. Attend Classes.   
Do you prefer a male or female? Male. Female.  Either.
Which type of golden are you looking for? English. American. Either.  
Color preference: Light Medium Dark  
Do you have small children, grandchildren or family with children that will grow up with the golden?  Yes. No.   If yes, please list ages. ________________________________________  
Are you willing to abide by a contract that specifies matters related to AKC registration, health, and  general care requirements? Yes. No.  
Do you have other pets, or have had past pets? Please list below.  ____________________________________________________________
Have you ever returned a pet to their breeder or placed one in a rescue? Yes. No.  If yes, please explain. ___________________________________________________________________  
What are you looking for in a golden retriever? Show/Breeding. Family Pet.  Is there an upcoming litter we have listed that you prefer? Yes. No.  
Why do you think a Golden is the right breed for you?  _______________________________________________________________  
Will you be able to come out and visit with us when choosing your puppy? Yes. No. 
Please tell us what important  traits you are looking for in your puppy.  ________________________________________________________________________  Do you have any questions for us? If so, please list below.  ________________________________________________________________________  ________________________________________________________________________  
Signature:_________________________________________  
As a courtesy to all families on our waiting list, if you find a puppy or decide that now is not the right  time for you to get a puppy, will you please email and let us know? ________________ Thank you for  considering Hyatts' Goldens.