Double T Jack Russell Terriers
Potential Puppy Buyer
Questionnaire
* Required Field
*
 Your name:
*
 Address,City
State, Zip
*
Home Phone:
Work Phone:
*
 E-Mail:
Occupation:
How did you find Double T JRT's?
What is your experience with dogs in
General?
Have you Ever owned a Jack Russell
before? Yes, No? If so When?
At what age did your Jack Russell Die? And
Cause of Death or reason for Euthanasia,
Placement, Sale, Etc?
Have you ever placed one of your dogs in a
new home or pound,and for what reason?
Why have you decided to buy a Jack Russell
Terrier?
Do you prefer a male or female?
For what purpose(S) are you purchasing a Jack Russell
Terrier?(pet, breeding, etc)
Do you have any young children in your household? If so
ages?
Do you live in a
House? Apartment?
Where will your Jack Russell be kept during the day? Will
someone be home with it?
Where will you Jack Russell be kept at night?
Do you have a securely fenced yard? Kind, Height, Size?
Is it adjacent to the house with an entrance to the house?
Do you own a kennel run?
Do you own a crate?
Are you willing to Spay or Neuter this dog? If not why?
Do you currently own any other dogs? If yes please list
the breeds, sexes, and ages.
Will these dogs be kept with the Jack Russell Terrier? If
yes which ones?
Do you own any other pets? If yes what types?
Do you understand that a Jack Russell Terrier is a very
energetic breed that needs plenty of exercise?
Are you willing to sign a written contract prior to
purchasing a puppy?
Please list 3 References Name, Address, Email, Phone, and
Relationship to you.
Name, Address, Phone Number if your Veterinarian:
Additional Comments: