City: State: Zip:
Phones: Home Work Mobile Pager
Number of family members:
Ages of children:
How many family members are home during the day?
If no one, who will care for the young pup?
Where will the dog sleep?
Do you: Own or Rent ?
How long at current address?
Is your yard fenced? Please note, we think all retriever puppies should have a fenced yard. Yes No
Describe your fence?
If you are planning an invisible fence, how will you contain the pup until it is old enough to use the invisible fence?
Explain why you want a dog
Who will be responsible for training the dog?
Do you plan to have the dog trained professionally? Yes No
Do you plan to have your dog spayed or neutered? This is up to you, but all our dogs are sold on Limited (nonbreeding) Registration. Yes No
What happened to your last dog?
How many other pets do you have now?
What kind are they, and how old?
If your puppy swallowed a sock and the veterinarian told you it needed an operation that
would cost $2400, what would you do?
Who is your current veterinarian, include phone number + area code
Have you used a crate to house train puppies before? Yes No
Have you trained any dogs to achieve titles? If so, which titles?
What hobbies do you have?
How many hours a week do you plan to spend with your dog?
Are you planning to move in the next 5 years? Yes No
What will you do with your dog when you go on vacation?
Are you prepared to make this commitment for the next 14 years? Yes No
Do you plan to use for dog for hunting? Yes No
What kind of hunting do you do?
How often did you hunt this past season?
Will you run your dog in any Field Trials, Hunt or Field Tests? Yes No
Who will train your dog for these events?
Do you plan to send your puppy back for puppy training at Deep Run Farm? Yes No
Will you want your pup shipped to you? Yes No
If yes, what is the nearest LARGE airport to you?
Will you want to buy a crate to ship your pup, or send one to us for shipping?
Which Deep Run litter are you interested in?
Are you interested in a male or female pup? Male Female
Please list your color preferences in order (Black, Yellow, Chocolate are the options)
(If you are only interested in one color, simply list that color.)
Thank you for taking the time to tell us more about yourself. We will give you a call soon. If you do not hear from us within 72 hours, call us, because we didn't receive your questionnaire.
You should see a yellow page titled "Your Request is being processed" after clicking on the "Submit Info" button.