Name
*
Address
*
City
*
State
*
Zip
*
Daytime Phone
*
Evening Phone
Email
*
Fax
Does anyone in your family suffer from DOG related asthma or allergies?
Yes
No
What gender do you prefer?
Male
Female
I am Flexible
List color in order of PREFERENCE (1-5)
Cream
1
2
3
4
5
Black
1
2
3
4
5
Gold
1
2
3
4
5
Chocolate
1
2
3
4
5
Red/Apricot
1
2
3
4
5
What coat type do you prefer?
Fleece/Curly
Fleece/Wavy
Wool/Fleece
Does your family have
Children
Elderly
Physically Impaired
If yes on children, age(s)
If your yard fenced?
Yes
No
If not, how do you plan to confine/protect your dog
Why are you interested in a labradoodle?
Is your lifestyle
Sedentary
Somewhat Active
Active
When would you like to take delivery of your Labradoodle?
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