Questionnaire and References

Lhasa Apso Breeder Questionnaire and References

KarLyn Lhasa Apso

AKC Breeder of Merit

ALAC Register of Merit – Breeder

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):