Goldworks Kennel and Kelore Golden Retrievers

Puppy Questionnaire

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Reserve your puppy by filling out this

Client Questionnaire

It is my responsibility to ensure my puppies a loving,caring home where they are part of the family unit. This application is designed to help me understand your home environment and to ensure you are in agreement with my breeding philosophy. I sell to clients who:

1. Enthusiastically agree to have their pet neutered before they reach sexual maturity. WE DO NOT SELL BREEDING STOCK.

2. Provide 24-hour supervision. For example, my puppies are not to be left alone all day while adults are at work. If this is necessary, arrangements for day care with older children, grandparents, pet sitters, etc. are satisfactory

3. Treat their puppy as part of the family unit. My puppies are not to be tethered to a tree or doghouse, on outside runs, or to be left out overnight.

In order to stay on the list for a pending litter, prospective purchasers must complete and return this questionnaire. Once we receive this questionnaire you will be placed on the list and notified when the pups are born.

If we have a puppy that meets your requirements we will expect a $200.00 non-refundable deposit. (Deposit refunds will be given only if there is no puppy available.) We encourage your calls during the first six weeks to check the progress of the litter and a visit to "play with the puppies" is always welcome after the puppies have been immunized, usually at six weeks of age.


Name(First and Last):

Street Address:

City: State: Zip:

Tel:(day) (evening:)


Your occupation:

Spouse's occupation:

Please describe the type of housing situation you are presently living in:

Where will the dog be all day?

If you travel out of town where will the dog be?

During the night:

Will you use a crate to train your dog?

Ages of adults and children in the home:

If you have other pets, please list:

Have you owned a Golden Retriever before?

If so,what happened to him/her?

Please list any specific requirements you would have of your next dog:

Do you have a fenced in yard?

What are your plans for this puppy?

References: Please list two personal references:








Vet Reference:




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