KarLyn Lhasa Apsos
Questionnaire and References
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):
Name:________________________________________________________________________
Address:______________________________________________________________________
Phone:________________________________________________________________________
Email/website__________________________________________________________________
Name:________________________________________________________________________
Address:______________________________________________________________________
Phone:________________________________________________________________________
Email/website__________________________________________________________________
Any other information that you would like us to know about you: