Why do you want a Golden Retriever?
Outside Pet     Gift            Companion    Other

Where will Golden Sleep?
In Crate          With Owner  Outside        In Basement       Other

How long will golden be left alone a day?
2-4 Hours        4-6 Hours    6-8 Hours     10-12 Hours       12+ Hours 

How are you containing the golden outside?
Tie Out           Leash          Fence          Acreage            Free Run

Have you had other pets? What happened?
No Pets           Gave Away   Lost            Hit By Car          Died            Still Have

If you still have current pets, who is your current Veterinarian?

If you have children at home, what are their ages?

Additional Comments