* PLACEMENT QUESTIONNAIRE *
Name(s):
Address:
Phone
1:
Phone 2:
Email:
Kennel (if applicable):
Website (if applicable):
Best way to contact you:
What particular dog/litter/puppy are
you interested in?
Please tell us about any
animals you currently own or have owned in the past, including why they are no
longer with you.
Tell us about your home and facilities
(house/apartment/location/fenced/kennel).
If interested in a pup, have you raised a puppy before? If so, what
breed?
Will this dog/puppy live inside or
outside?
If you work outside of the home, where will this
dog spend the day? How many hours per day will this dog spend
alone?
Where will this dog go if you leave on vacation
or become suddenly ill?
What are your plans for this dog?
(pet/stockdog/conformation/performance)
Have you ever shown or titled a dog before? If
yes, please explain.
Are you a member of any dog clubs or
associations? If yes, please list them. Have you ever been in bad standing with
any of them?
Have you ever been turned in to animal
control?
Have you ever returned a dog to its breeder? If
yes, please explain why.
Do you have any dog/puppy preferences?
(age/color/gender)
What price do you expect to pay?
How much do you expect to spend on vet care for
this dog per year?
Do you plan to breed this dog? If not, are you
prepared to spay/neuter this dog at the proper age?
Have you ever bred dogs before?
If yes, what steps were taken to prevent hereditary diseases? Do you sell on
contract? Do you breed before 2 years of age or after 12 years of
age?
Any accidental
breedings?
Do you own livestock?
Please explain your family situation
(number of immediate members/ages/lifestyle).
If you have children, what steps will be taken
to ensure that they have a healthy relationship with this
dog/puppy?
Who is this dog/puppy primarily for?
Have you ever owned an Aussie
before?
Why did you choose an Australian
Shepherd?
What kind of research have you done on this
breed? Please list resources.
How do you plan to handle or channel this dog’s
energy?
How did you find out about us?
Please give 2 references (include name, address, phone
number, email if known, and relationship to you, i.e.
family/veterinarian/breeder, etc.)
Are you willing to allow a representative
of our kennel to come visit your facilities?
Do you have any additional
information you would like to share with us?
THANK YOU for your interest in our Aussies and for completing our questionnaire!
Please copy questionnaire to an email or print and send to us via fax or regular mail.
Chris & Esther Ivey * P.O Box 1216, Bloomfield, NM 87413 * fax: (505)333-2662 * estabe@hotmail.com
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