Heartland Golden Retriever Companion-Puppy Questionnaire

Your Name(s):

Street Address:

City, State, Zip:

Email address. Please be careful to enter it correctly so we can respond to your request.

Phone number where you can be reached.

Prefer evenings or days, or does not matter?

Are there other adults in your household?

Are there children in your household? If so, please list their ages.

Have you owned a Golden Retriever before? If so, please tell us about your Golden Retriever(s).

Tell us why you have decided that the Golden Retriever is the best breed for you.

How many hours a day will this puppy be alone? Please explain below.

What pets are currently living in your household?

Where will your puppy be living? Please mark all that apply.
With us indoors Outside in kennel Fenced in yard Outside in Country Setting

Who will be responsible for training your puppy?

What are your plans for house training your puppy?

Will you be taking this puppy to training classes? Obedience training? Other activities?

Are you interested in showing this puppy in dog show events? Please explain below.

How do you plan on filling your puppy's needs for exercise. Check all that apply.

Other exercise you would like to mention enter below.

Are you a breeder? Yes No
Are you planning to spay/neuter this pet? Yes No
Would you prefer a male or female puppy? Male Female No preference
Do you have a puppy/dog size preference? Smaller Medium Larger No preference
Do you have a golden color preference? Lighter Medium Darker No preference

Please enter below any temperment preferences you have for your puppy.

Would you like me to email you information about upcoming litters? Yes No
Are you interested in a well trained adult Golden Retriever? Yes No

If someone recommended you to us, please enter their name and phone number below.

Home Page Litter Info Heartland Champions Show Highlights Services Contact Us