Golden Tu Lhasa Apsos

Lhasa Apso Bteeder

Golden Tu   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:

1. Have you ever had a lhasa apso before in your household? Yes or No    (circle answer)
2. If Yes, when did you have a lhasa and for how long? _____________
3. How many dog(s) in the current household?____________________
4. What kind of dog(s) and ages? ______________________________
5. Do you own any cats?  Yes or No Indoor or Outdoor?
6. Do you own any other pet(s)? Birds, reptiles, hamsters, gerbils, etc.… Yes or No

What type? _____________________________________

Family Members in Household:

1. How many family members in your household? ____________
2. How many are under the age of 6 years of age? _____________
3. Who will be the primary caretaker? _____________________

Employment

1. Are you currently employed? Yes or No
2. Is spouse or partner employees? Yes or No

Home:

1. Do you have a fenced in area for the dog(s)? Yes or No
2. If not how do you plan to exercise and potty the dog(s)?
3. 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):

1. High or Low
2. Busy all nights or Couch potatoes
3. Travel on the weekends Yes or No
4. 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: