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Fill out the form below. Please complete all sections of it.
List family members present during home visit and approximate ages (also list anyone not present ).
Is this a rental? If so, do they have written approval from landlord? (If YES, get a copy or take a photo of agreement).
Describe the inside of the house. Is it safe for a dog? Is there a lot of stuff on the counters? Make sure to explain the dangers of counter surfing.
What kind of flooring do they have? Are the stairs carpeted?
Describe the size/dimension of the yard (describe layout). Is there shade?
Is there anything in the yard that creates a hazard for the dog (broken fence, nails sticking out)? Are there planters, furniture, shelves, or anything that would help a dog jump over the fence?
Describe the fencing in any area where the dog will have access. Are there any escape routes?
Are the gates padlocked? What type of locking mechanism is there?
Who has access to the yard? Where are the utilities located? How is the dog(s) contained when the lawn person, pool person, etc. come into work?
Describe the swimming pool area. Is it fenced in? Is the owner aware of good pool safety (training the dog how to get out)?
Will the dog have access to the garage (if so, are there any hazardous materials evident, snail bait, fertilizers, etc.)?
Where will the dog be kept when the family is away from home (if outside is there shade)?
How will the pet be cared for when the family goes away for an extended period of time?
Describe any pets in the home. Do they appear well cared for? Do you see evidence that they are allowed in the house? What is the dog(s) energy level?
Where will the dog sleep?
What is the activity level of the applicants? What kind of activities will they share with the dog?
What are the applicants looking for in a dog? What do you think will work best for them?
Would you leave your dog here? Any additional comments?
Did you discuss the adoption process with the family?
Home interviewer's name:
Date of interview:
Has the applicant paid the $30 home Check Donation? Paypal or Check?