Wufoo

Name * First Last
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email *
Phone Number * ### - ### - ####
Do you rent or own your home? Renters are required to provide a letter from your landlord giving permission to have a dog.
If there are children under 18 in your household, please indicate their names and ages.
Do you have an existing relationship with a veterinarian? If yes, are you willing to provide contact information we can use as a reference?
yes, I have a vet and you may contact him/her (name and phone listed below) no, I don't have a vet yet
Please provide name and phone number for your veterinarian
Will this be primarily an indoor dog or primarily an outdoor dog?
Are you willing to allow the breeder or a representative to visit your home by appointment before the puppy is delivered to you?
Have you ever met any flat-coated retrievers in person?
yes, have owned at least one flat-coated retriever previously/currently yes, a friend owns them/we have visited a local FCR owner yes, we've seen them at shows or other events no, we've only seen them on TV no, we've only seen them online or read about them in a book not sure, we had/have a dog that looks and acts like a FCR, but was a rescue
Please choose a personality type that appeals to you in a dog:
bold and outgoing - high energy! mischievous/bratty quiet and submissive - low energy (couch potato)
Do you plan to enroll in a puppy or obedience class (we encourage this!)
yes, definitely; the new pup is already signed up! yes, we're shopping for a suitable class now no, we always do our training at home undecided; time is tight and classes will be hard to make every week undecided, classes are very expensive in my area
Are there times in the day when no one is home at your house?
rarely; someone is home almost all the time often; we both work full-time sometimes
Where will your dog stay while you're gone?
in a crate in the living area (bedroom/kitchen/living room) in a crate in the basement/garage outside in a fenced yard outside in a kennel run/pen loose in the house will go to work with me other

If clicking "other", please add details in the next field
Where will your dog sleep at night?
in a crate in the bedroom in a crate in a room other than the bedroom in the basement/garage loose in the bedroom loose in the house in an outside kennel
Have you ever housebroken a puppy before?
yes, at least one no, this will be my first!
Are you opposed to crates or crate training?
How would you describe your lifestyle?
very active (hiking,travel, play sports) homebody (gardening, reading, watch TV) other

Please describe your lifestyle more completely in the text box
Please describe "other" here
What are your favorite activities (individually and as a family)
Have you had any dogs die young (under 8 years of age)? If yes, please tell us how they died (illness, accident, etc).
Have you ever rehomed a dog, or returned it to its breeder? If so, please give us a brief explanation of why you did so.
Do you currently have other dogs/cats/pets?
Do your other pets live in the house?
yes no
Please tell us a bit about their personalities (if applicable)
friendly to other dogs hostile to other dogs disinterested in other dogs shy/timid bold/outgoing
Do you plan to walk/jog/hike with this dog?
Describe your personality and those of the family members living in your home (be nice!!)
Would you consider an older dog if one were available?
no, we really love puppy breath! yes, if it was the right fit for us tell me more...
Will you consider purchasing pet insurance to offset any potential injuries or health crises that may occur?
yes, that seems like a great idea! no, it sounds too expensive not sure - we'd like to research it more
Would you consider co-owning a show/breeding quality prospect with us? It involves special arrangements we would be happy to discuss with you
yes, we are open to that possibility no, we really prefer our dog to be our own pet not sure - tell us more
If you are purchasing a show/working dog, what activities are you interested in?
show championship special/top 10 hunting dog (upland and/or waterfowl) hunt test competitions field trial competition obedience competition - basic levels (CD/CDX) high level obedience obedience competition (UD/OTCH) agility competition registered therapy dog tracking I have never participated in any organized dog sports, so not sure if I want to do any of them!
If you are purchasing a show/working dog, what is your level of experience?
I have owner-handled 1 or more show champions in this or another breed I have used a handler to finish 1 or more show champions in this or another breed I have previously specialed 1 or more champions to national rankings I have bred 1 or more litters in this or another breed I have titled 1 or more obedience/agility/hunt test/etc in this or another breed I have shown but not finished at least 1 dog of this or another breed I have dabbled in obedience/agaility/hunt tests/etc but not formally competed I have owned a stud dog in this or another breed I have not ever bred a litter/owned a stud dog of any breed I am a complete beginner, but willing to accept mentoring and direction I am a complete beginner but prefer to be "on my own"
Please add any additional details you think we should know about you and your family. If you are sending a questionnaire and have not contacted us for a contract, etc., please be sure to introduce yourself here! Failure to introduce yourself may result in no response.
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