Your name:

Street Address:

City:

State:

Zip:

Phone number:

E-mail:

Good time to call if we need to reach you:

How were you referred to us?

Are you interested in obtaining one of our Goldendoodles for:

Additional Comments:

What qualitites do you like in the Goldendoodle breed?

Is this your first Goldendoodle?

Previously owned dogs:

Animal present in the home:

Are you committed to caring for this dog for its lifetime (approx. 15 years)?

Are you willing to spay/neuter this dog?

If not, why?

If you are considering breeding, do you promise to have this dog OFA certified for hips, eyes, and cardiac (a $300+ expense) and to consult us prior to breeding?

Family Information

Children's ages

Occupation of adults in family:

Others in household that will have contact with dog:

Do you live in:

Where will the dog stay during the day?

Where will the dog stay during the night?

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