Kerifield Kerry Blue Terriers

Questionnaire for Screening Potential Puppy Buyers
For upcoming or Existing Litters

Thank you for your interest in Kerifield Kerry Blue Terriers. This is a questionnaire that will help us become acquainted with prospective owners for one of our puppies. The information you provide will guide us in placing the right puppy in the right home; to ensure the greatest possibility of success for a happy life together. This is not a contract and does not guarantee you a puppy. At Kerifield Kerries we interview prospective buyers very carefully to make sure a Kerifield puppy will be a good match for you and your family.

A. Your Family

Name:__________________________________________________________________________________

Address: ______________________________XXXXXXXXXXXXXXX	Email: ____________________
City/State:_____________________________	Fax Number:________________
Home Phone:___________________________	Work Phone:_________________

1. Do you currently reside in a house, duplex, apartment or etc? ____________________________________

2. Do you have a securely fenced yard? YES NO If yes, how high is it? ________________________

3. If no, how will you restrain your puppy? ____________________________________________________

4. Please list who lives with you and their ages. _________________________________________________

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5. If you have children what has been their experience with dogs in the past? __________________________

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6. Do you have a pool? YES NO

7. Does anyone in your family have severe allergies? Please specify. ________________________________

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8. Please tell us who wants a dog in the family and how all family members feel about getting a new puppy.

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B. Why A Kerry Blue Terrier?

1. What do you know and like about Kerry Blue Terriers and how did you first learn about the breed?

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C. Ownership History

1. Have you owned a dog before or is this your first? ______________________________________________

2. What breeds have you owned and were they male or female? (spayed or neutered?)____________________

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3. Describe your relationship with these dogs and how long they lived with you. ________________________

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___________________________________________________________please use the back for extra space.

4. Are you interested in a conformation show dog? YES NO

5. If yes, have you ever shown dogs before? ____________________________________________________________

6. Do you have any future plans for obedience, agility, performance or therapy work for your dog? __________________________________________

7. Do you have any plans to breed this dog? YES NO

8. If yes, why are you interested in breeding? ____________________________________________________

9. If no, would you be willing to sign a spay/neuter agreement and accept limited registration? _____________

10. Please list any other pets you have at this time that will be living with your new Kerry puppy. ___________ _______________________________________________________________________________________


A Kerry's lifespan can be from 10-15 years.
Are you committed to caring for this dog its whole life?


D. Care & Responsibility

1. How much time do you have to spend with your Kerry? __________________________________________ _______________________________________________________________________________________

2. Who will be home with the puppy? __________________________________________________________

3. Approximately how many hours during the day will the puppy be left alone? _________________________

4. Where will your Kerry spend the day? ________________________________________________________

5. Where will your Kerry sleep at night? ________________________________________________________

6. Kerries need exercise. How do you plan to play with or exercise your Kerry daily? _________________________________________________________________________________________________________

7. Do you have favorite activities you plan to include your Kerry in?__________________________________ _______________________________________________________________________________________

8. Do you have a vet you have used in the past or plan to interview one to care for your new puppy? YES NO

9. Please provide us with the name, address and phone number of the vet you plan to use.

Name: ______________________________XXXXXXXXXXXXXXX	Phone: ____________________
Address:_____________________________	Email:________________
City/State:___________________________

10. Are you familiar with the costs of both routine and emergency care of a dog? YES NO

11. A Kerry Blue Terrier does not shed or have a dog smell if groomed regularly but is a high maintenance dog.

Are you prepared to brush your Kerry nearly every day and either pay someone every 4-6 weeks to groom your Kerry or buy the necessary equipment and learn to groom your Kerry yourself? _________________ ______________________________________________________________________________________ ______________________________________________________________________________________


A puppy is an investment of time, money and love!!!


E. Behavior & Training

1. Are you familiar with and are you prepared to crate train your puppy? _____________________________ ____________________________________________________________________

2. Do you plan to participate with your puppy in Basic Obedience Classes? YES NO

3. How do you plan to socialize your puppy? _____________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________

4. What amount of time and effort do you have to devote to training your puppy? ________________________ _______________________________________________________________________________________ _______________________________________________________________________________________

5. What type of behavior do you expect of this breed? _____________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________

6. What is your definition of disciplining a dog? __________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________ _______________________________________________________________________________________

F. How did you find out about us?

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G. Preferences - Male or Female

Although we reserve the right to match a puppy with a suitable owner, we will try to take into consideration your preference. Please indicate your first preference for gender and how important it is.

Male _________________________

Female _______________________

No Preference__________________

H. References

Please list three references with their phone # and/or e-mail addresses.

1. ________________________________________________________________________________

2. ________________________________________________________________________________

3. ________________________________________________________________________________

If there is ever a situation where you can't keep your Kerry ( FOR ANY REASON - AT ANY TIME IN THE DOGS LIFE ) would you be willing to contact us and assist in returning him/her back to us? _______ Would you be willing to sign an agreement in regard to this? _________

Thank you for completing our questionnaire. Please return it to us at the address below. We will contact you to set a time for a phone interview after reviewing this information. We take our responsibility as breeders very seriously and encourage all new owners to keep in contact with us throughout the life of their dog. We fully guarantee the health and well-being of our puppies. Both pet and show puppies are sold with a contract. We are always available to give advice or just share in the joy a Kerry can bring to your family. Our Kerries are members of our family and we expect a Kerifield puppy will be a welcomed member of your family as well. Hours of socialization and human interaction make our puppies outgoing, affectionate and confident. If you have any questions for us, please don�t hesitate to ask.


Virginia Payson
19090 N. Hwy 329
Micanopy, Florida 32667
352-591-0153
kerryblu@windstream.net