Prospective Buyer Qualification Form

Please take a moment to fill out the form below to the best of your ability. If you are interested in purchasing a pup from Southern Redheads Farm and Kennel, we require that you fill out the qualification questionnaire below. If you have any questions about the form, please feel free to call us at (239) 777-0970 or email us at info@southernredheadskennel.com.

Personal Information

Full Name *

Street Address

City

State

Zip Code

Your Email *

Home Phone

Mobile Phone


Family Information

Do you own your home?
YesNo

Have you ever owned a dog before?
YesNo

If "Yes," what breed?

Please list all current pets in household

Who will be the primary care giver(s)?

Are there children in the household?
YesNo

If "Yes," what are their ages?

Does anyone in your household have allergies to animals?
YesNo

Do you have a fenced yard or outside kennel?
YesNo

What is the size of your property?

Have you ever returned a pet to a breeder?
YesNo

If "Yes," what were the circumstances?

Have you ever surrendered your dog to an animal shelter or given it away?
YesNo

If "Yes," what were the circumstances?


About the Puppy

Where will the puppy be kept during the night and/or day?

Is anyone home during the day/how long will the puppy be left alone?

Will the puppy be kept outside?
YesNo

If "Yes," what part of the day?

How will you accommodate the activity needs of the dog?

Do you plan to have the dog obedience trained?
YesNo

Are you interested in competition events such as obedience, agility, hunting, herding, etc.?
YesNo

Do you have any intentions or plans to breed?
YesNo

Are you planning on spaying/neutering?
YesNo

Do you have any additional information you'd like to share with us?

Privacy Policy

For your information

Every one of our puppies will be micro-chipped. Each puppy will receive an Official Certificate of Veterinary Inspection which will be completed by a licensed Veterinarian. They will be current on all vaccinations, and deworming, They come with a health guarantee.

Southern Redheads Farm & Kennel holds a DAS Breeders permit: P15-004998. We are inspected by Collier County DAS quarterly, who inspect the premises where the animals are kept to assure compliance with Proper Animal Husbandry and Breeder Regulations.