* PLACEMENT QUESTIONNAIRE *
copy & paste questionnaire into an email
or print, complete & send to us via regular mail.
Phone 1: Phone 2:
Kennel (if applicable):
Website (if applicable):
Best way to contact you:
Your Age: Occupation:
How did you find out about us?
Which particular dog/litter/puppy are you interested in?
If interested in a pup, have you raised a puppy before? If so, what breed?
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).
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?
Will this dog at any time be tied out or chained?
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? (4-H Dog Projects included) 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? If yes, please explain.
Are you or have you ever been in direct association with North American Australian Shepherds, Miniature Australian Shepherds and/or Toy Australian Shepherds? If yes, please explain.
Have you ever participated in a dog auction? If yes, please explain your involvement.
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?
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?
Please give 2 references (include name, address, phone number, email if known, and relationship to you, i.e. family/groomer/breeder, etc.)
Please list your Veterinarian's name, contact information, and how long you've been using them:
Are you willing to allow a representative of our kennel to come visit your facilities?
Have you read through our Sales Contract?
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!
Chris & Esther Ivey * P.O Box 1216, Bloomfield, NM 87413 * email@example.com
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