Questionaire and References

Lhasa Apso Breeder Questionaire and References

KarLyn Lhasa Apso

AKC Breeders of Merit

ALAC Register of Merit – Breeders

Lhasa Apso Puppy Questionnaire and References


Circle Answer or Fill in the Blank

The more information you provide the better for us to decide on the puppy for you.

Name: _______________________ Address:_______________________ Phone: ________________ Email: _______________


Dog Ownership:

Have you ever had a lhasa apso before in your household? Yes or No (circle answer)

If Yes, when did you have a lhasa and for how long? _____________

How many dog(s) in the current household?____________________

What kind of dog(s) and ages? ______________________________

Do you own any cats? Yes or No Indoor or Outdoor?

Do you own any other pet(s)? Birds, reptiles, hamsters, gerbils, etc.… Yes or No

What type? _____________________________________


Family Members in Household:

How many family members in your household? ____________

How many are under the age of 6 years of age? _____________

Who will be the primary caretaker? _____________________


Employment

Are you currently employed? Yes or No

Is spouse or partner employees? Yes or No


Home:

Do you have a fenced in area for the dog(s)? Yes or No

If not how do you plan to exercise and potty the dog(s)?

Crates for safety of the dog(s) – have you trained one to use crate before? Yes or No Travel in a crate is for the safety of the lhasa.

Activity Level(s):

High or Low

Busy all nights or Couch potatoes

Travel on the weekends Yes or No

Take dog(s) with on trips Yes or No






References: (if this is your first dog – leave blank)

Veterinarian: Name:________________________________________________________________________

Address:______________________________________________________________________

Phone:________________________________________________________________________

Email/website :_________________________________________________________________

Years as your veterinarian: ________


Groomer:

Name:________________________________________________________________________

Address:______________________________________________________________________

Phone:________________________________________________________________________

Email/website__________________________________________________________________

Currently being used: Yes or No


Friend(s) or co-worker(s) who knows the dog(s) in your household – familiar to dog(s):

Name:________________________________________________________________________

Address:______________________________________________________________________

Phone:________________________________________________________________________

Email/website__________________________________________________________________


Name:________________________________________________________________________

Address:______________________________________________________________________

Phone:________________________________________________________________________

Email/website__________________________________________________________________


Any other information that you would like us to know about you: