Lap Top Yorkies Questionnaire
Please complete our questionnaire below. We will contact you to clarify any
questions and to notify you of your application status.
* indicates required field
*Your Name:
*Your Email Address:
*Your Phone Number:
Google/Internet Search
Website
*How did you hear about my dogs?
Facebook
Friend/Reference Referral
If referral, who can we thank?
Other
*Why do you want a dog?
*Have you owned a dog before?
Yes
No
If so, have you owned a Yorkie
before?
Yes
No
If not, have you researched the breed?
Yes
No
*Who will be the primary care giver?
*Are there young children in your home?
Yes
No
If so, what are their ages?
*Do you have any other animals?
Yes
No
If so, what kind?
*How many hours a day will the dog be left
alone?
*Where will the dog stay when the family
is home?
*Do you have a fenced yard?
Yes
No
If not, what are your plans to contain the
dog while outdoors?
*Are you able to maintain the dog's health and well-being with necessary
medical care, regular veterinary checks and appropriate vaccinations?
Yes
No
*Have you ever had to re-home or euthanize a family pet?
Yes
No
If so, what were the circumstances?
Are you interested in a:
Male
Female
No preference
Are you interested in a specific Yorkie that we currently
have listed?
Yes
No
If so, which one?
Is there a particular adult size that you are looking for?
Yes
Doesn't matter
Is there a particular adult color that you are looking for?
Yes
Doesn't matter
Does everyone in the home agree with having a new pet?
Yes
No
Still working on it
*Are you prepared to make a 12 to 15 year commitment to love and care for a dog?
Yes
Not sure
Please add any additional pertinent information below:
Thank you for completing this questionnaire. Please know that it is not our intent to
invade your privacy. The purpose of these questions is to find responsible, caring
permanent homes for our puppies. We will review the questionnaire and contact
you shortly.

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