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Captivate Goldens, LLC

Marianne & Larry Miller

www.captivategoldens.com

801-368-1400

Potential Puppy Buyer Questionnaire

Name:

Address:

City: State: ZIP:

Home Phone: Cell Phone:

Email:

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Do you prefer a male or female puppy? Male Female Either

For what purpose are you purchasing a puppy?

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Do all family members want a puppy? Yes No

If no, please explain.

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Do any family members have allergies to dogs? Yes No

Do you have any other pets? Yes No

If yes, are they spayed or neutered? Yes No N/A

If you need more space to explain, please do so below.

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Do you live in a home with a yard? Yes No

What size is your yard?

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Is the yard fenced? Yes No

Are your gates kept locked? Yes No

Do you have a swimming pool? Yes No

Is the pool fenced? Yes No

Where will the puppy be kept?

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How long will the puppy be left alone during the day?

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Do you have a schedule for someone to come and
potty the puppy during the day if you are at work? Yes No

Please give any details.

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Have you ever owned a puppy? Yes No

Have you ever owned a Golden Retriever? Yes No

Are you aware that a Golden Retriever sheds? Yes No

Do you plan to crate train your puppy? Yes No

Do you plan to take your puppy
to obedience / puppy training classes? Yes No

Are you willing to spay / neuter your pet? Yes No

If buying a show quality puppy, are you willing
to co-own the dog until you have all clearances

(hips / elbows / eyes / heart)? Yes No N/A

NOTE: At the time all clearances are completed we will sign off as a co-owner.

If you decide to reserve a puppy,

do you agree to a non-refundable deposit? Yes No

Please tell us a little bit about you and your family.

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Thank you for filling out this questionnaire and for your interest in a Captivate Goldens’ puppy. We will be staying in touch with you as we have litters available.

Captivate Goldens, LLC: Potential Puppy Buyer Questionnaire Page 3