PLACEMENT QUESTIONNAIRE
Name::
Home Address::
Phone::
Email::
Family Members (children's age)::
Do you have a fenced yard? Describe.:
Do you have a swimming pool? Is it dog safe? Describe.:
Do you have any pets?: yes no
If yes, please list type & age.:
If you work outside your home how many hours would the Tibetan Spaniel be left alone?:
Describe how the Tibetan Spaniel would be kept safe if left alone.:
Your Veterinarian's name, address & phone #.:
List two references (other than family) & phone numbers:
Would you be willing to let someone do a home visit?: yes no
Why are you interested in a Tibetan Spaniel?:
Are you interested in a male or female? Explain why.:
Are you interested in a puppy or adult?:
Are you willing to have your Tibetan Spaniel neutered or spayed?: yes no
If no please explain.:
How did you find TAMZIL TIBETAN SPANIELS?:
Please list any information that might be important in placing a Tibetan Spaniel with you.:
Please type the text below: