Name:

Address:

Phone:

Email address:

1.          Type of dwelling? _____house _____condo _____apartment.

2.         If renting, please give name, address and phone number of landlord.

3.         Name, address and phone number of veterinarian.

4.         Who will be primary care giver?

5.         Where will the puppy be kept during the day?

6.         How many hours on the average will the puppy be home alone?

7.         Is anyone home during the day?

8.         Will someone be able to exercise and feed the puppy during the day? 

9.         Have you ever owned a dog before, if so, what breed?

10.     Do you have any other animals?

11.       Do you have any children, or are there frequent visits by children?

12.     If you do have children, what are their ages?

13.     Does anyone in your household have any allergies to animals?

14.     If yes, to what are they allergic and how severe is the reaction?

15.     Are you interested in a male or female puppy?

16.     At what age do you wish to get the puppy?

17.     Have you considered adopting an older dog?

18.     How did you hear about this breed?

19.     Do you know anyone personally with a Golden Retriever/Havanese?

20.     What do you expect the activity level of this breed to be: _____very high _____high _____moderate _____ below average?

21.     What kind of surfaces will the puppy be on in your home?

22.     How many hours a day will the puppy be kept outside?

23.    How will he be confined when outside?

24.     Do you have a fenced yard or kennel area?

25.     If you do not have a fenced yard, would you consider fencing it?

26.     Have you ever house trained a dog before?

27.     How do you feel about crate training a puppy?

28.     Do you plan to take the puppy for obedience training?

29.    If yes, at what age do you plan to start attending training classes, have you considered a puppy kindergarten class?

30.    What is the name of the training facility?

31.     How long did your last pet live?

32.    What were the circumstances of his/her death?

33.    Have you ever returned a pet to the breeder:  if so, what were the circumstances?

34.    Have you ever given a pet away, or brought it to an animal shelter:  if so, what were the circumstances?

35.    Are you interested in showing this puppy in the conformation ring?

36.    Have you ever shown a dog to its championship?

37.    Are you interested in competition or performance events such as obedience, agility, hunting etc?

38.    Have you ever shown a dog to any performance titles: if so, what title(s)?

39.    Do you intend to breed the dog?

40.    Do you understand the difference between a “limited registration” and a “full registration”?

41.     Have you calculated the cost of owning a dog?  Initial purchase price, puppy shots, annual vet exams, spay/neuter, emergent vet care if needed, food, training classes etc?