Potential Puppy Purchaser Questionnaire Thank you for your expression of interest in an Adirondac Golden. Your assistance in completing this questionnaire will help us match your temperament to Puppy's. Information you provide Adirondac Goldens will only be used to ensure that you receive the best puppy for your family. We do not sell or share any personal information you provide with third parties. PERSONAL INFORMATION First Name: (Required Field) Last Name: (Required Field) Street: City: State: Zip: Phone: (Required Field) Cell: Email: (Required Field) How did you learn about Adirondac Golden Retrievers?      Please check all that apply: Past Experience Recommended by a Friend Internet Search Saw us in Action at Hunt Tests, Shows or Demos Other : How soon will you be ready for a puppy? Immediately 3 - 6 Months    WE DO NOT SHIP PUPPIES.     Will you be able to pick up your puppy when it's ready to go home?    Yes    No PUPPY QUESTIONS Gender Preference: Male      Female    No Preference Size Preference: Smaller    Medium    Large   No Size Preference Coat Preference: Curly     Flat   No Coat Preference Color Preference: Light     Dark     No Color Preference Do some white markings matter to you? Yes    No Personality Preference: Sensitive, sweet, cautious Upbeat, outgoing, assertive, bold Activity Level: High energy performance dog     Moderate energy    Quiet and laid-back Are you interested in a particular breeding? Particular Breeding HOUSEHOLD QUESTIONS Why have you decided to add a Golden retriever to your life? Had Goldens before Reputation of the breed Recommendation of others Vet referral Result of research about the breed Other Is there anything else that you want me to know about you? Are you aware of the common (unfortunate) health problems of Goldens? Yes     No Have you ever had a Golden before? Yes     No Have you had or do you now have other pets? Yes     No If Yes, Please describe: How many members are in your household?: Ages?: Would you consider your lifestyle: Active     Sedentary Do all family members want a new puppy? Yes     No     (Please tell the truth) Who will provide primary care and training?: Do all adults in the household work full time outside the home? Yes     No How many hours a day will the puppy be alone? Will you use a crate? Yes     No Have you ever completed an AKC title in Obedience? Yes     No Have you ever completed an AKC title in Field? Yes     No Does anyone in the household smoke?: Yes     No Do you plan to spay/neuter?: Yes     No If Yes, Why: For what purpose(s) are you seeking a Golden? Competition (Field, show, agility, obedience, etc) Athletic (Jogging, boating, camping, hiking, etc) Hunting, Gun dog SAR, Specialized Training Family, Companion, Therapy Breeding BY CLICKING SUBMIT FORM BELOW, I AGREE THAT I HAVE ANSWERED THESE QUESTIONS CAREFULLY AND UNDERSTAND THAT THE PUPPY SELECTED WILL BE BASED ON THIS INFORMATION. I AM WILLING AND ABLE TO TAKE THIS DOG TO OBEDIENCE CLASSES IN ORDER THAT HE/SHE WILL BECOME AN ENJOYABLE COMPANION AND A GOOD CANINE CITIZEN:

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	Carol Lantiegne 239 Fravor Road Mexico, NY  13114 - 315-963-8403   Email:  puppies@adirondac-goldens.com		Would you like to find out more about the Central New York Area? Eastern Lake Ontario.com
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