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: