Rescue Home Visit Form
For Adopters or Fosters
Today's Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Dog Name:
Applicant's Name
First Name
Last Name
Applicant's Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Applicant's Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Applicant's Email
example@example.com
Volunteer Name:
First Name
Last Name
Volunteer Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Volunteer Email:
example@example.com
Describe the traffic in the area:
busy, moderate, quiet..... are roads unmarked in the street/double yellow line, etc.
Did you see any distractions which might encourage the dog to leave the yard?
neighbors, children, other dogs?
Size of the yard:
Tiny
Small
Medium
Large
Xlarge
Farm
No yard at all (apartment/condo)
Other
What was the condition of the yard?
junk piles, weedy/possible tick are, mowed, well kept, etc.
Is the yard fenced in? If so, describe the type of fence, materials, height & dimensions:
physical fence/invisible fence, vinyl/ chain link, farm fence, etc.
Where will the dog relieve itself?
designated area? anywhere?
If the dog has an accident in the home, how will they react and correct the dog? (Explain that even the best trained dogs might have an accident during the transition period.)
Describe the home interior:
Cluttered? Lots of furniture and knick knacks? Spacious and easy to maneuver? Clean or dirty? Hazards such as poisonous plants, coffee, chocolate, onions, cords where a dog can reach?
Describe the basement:
Finished? utility & storage? free of hazards/cleaners that animals would have access to?
Describe the garage:
Attached? separate building? free of hazards that are accessible? working doors?
Describe any out buildings:
garden sheds/barn? working doors? free of hazards?
Are their stairs in the home? Stairs outside the home? Any entrance without stairs?
Carpeted? bare? steep? easy to climb?
Did you meet their current pets? Are they well cared for?
If applicable, how do the children treat current pets?
respectful, needs work or tormenting
If applicable, how do the children listen to the parents?
If the parent tells the child to stop doing something while you were there did, they stop or ignore the request
If applicable, were the parents patient when dealing with the children?
This can give us insight if they will lose their patience if the dog misbehaves or has an accident.
How does the family interact with each other?
friendly, respectful, controlling, argumentative
If your opinion is this dog a good fit for the family? (Please know the dog you are doing the visit for. If the dog is timid , it should not be in a home filled with young children. If the dog is energetic, is there room for it to release energy and exercise?)
Are the adopters physically capable of controlling and caring for this dog?
An elderly/feeble adopter planning to walk a large, high-energy dog once a day around the block is not reasonable.
How many hours a day will the dog be alone?
Where will the dog be when applicants are not home?
Will the dog be crated? Where will the crate be placed and how long will the dog be in it each time? (Ask to see the crate to check for the proper size for the dog. If they don't have it yet, suggest a size for the dog in question.)
Where will the dog sleep at night?
Where will the dog go when you are unable to be home to care for it? (vacation, family emergency, holidays? Boarding? Pet sitter?)
As the person conducting the home visit, if you were going on vacation, would you feel comfortable leaving your dog in their care?
Home Visit Volunteer Additional Comments or concerns:
Did they have any questions for you or the rescue? (If as the home visitor volunteer you cannot answer any question, tell them you will forward the question(s) to the directors and they can expect answers within 24-48 hours.)
Submit
Should be Empty: