Puppy Questionnaire

In order that we may effectively appraise the suitability of placing a Rebelcreek Golden Retriever with your family we require you to answer the following as concisely and completely as possible.

Upon receipt of your answers we'll determine the suitability of your family and home and will advise you of our decision.  Please remember, there are no right or wrong answers as each situation is unique and different.


City State/Province, Zip Code:    




When are you looking to add a golden retriever to your family?        

Describe your family:           

Why have you decided to buy a golden retriever? 

Are all family members in agreement on getting a dog?                    Yes       No

Are all family members in agreement on getting a golden retriever?   Yes       No

What type of housing do your live in?  Choose one:   

Where will your dog live? 

Do you have a securely fenced yard?                                    Yes           No

Do you have a pool?                                                             Yes           No         

If so, is is separately fenced?                                  Yes           No

Are you aware of the care requirements
of a golden retriever? 

Are you aware of the grooming requirements 
of golden retrievers?                                              Yes 

Are you aware of the attention and exercise requirements?                                                       Yes     

Are you aware that goldens shed a lot?                    Yes           No


What breeds of dogs have you owned in the past?           

What has happened to the dogs you've owned?               

Do you prefer a male or female and why?                          


Is someone home through the day?                           Yes        No

If not, what arrangements will you make?        

How will you housetrain your puppy?               

How will you obedience train you puppy?         

For what purposes are you buying your puppy?   Check all that apply ....

Pet        Show     Obedience      Field
Agility    Pet Therapy   Breeding     Other

If for breeding are you aware that the puppy will be sold on a Non-Breeding Agreement
pending fulfillment of the criteria as set out in our
Agreement of Sale?                                              Yes        No

Have you ever been in any AKC or CKC competitions and put any titles on your dogs?                        Yes        No

If yes, please describe: 

Have you ever bred dogs?    Yes        No              

If yes, please explain:             

If you have a veterinarian may we contact him/her for a reference?                                                    Yes        No

Please provide his/her name, address, and phone number:                                 

Please list two other references with contact information that we may contact:            

If you've had dogs before, please list from whom your other dogs were purchased:    

Please include any other information you feel would be helpful: