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Name of Home Visit Volunteer
Date of Visit
How many people are in the family?
Are children respectful of pets (your observation)?
How do family members react to each other?
Is the main caretaker physically able to care for dog?
Describe the street
Describe the setting
Condition of the home
Condition of the garage
Are there a lot of stairs?
What type of flooring do they have?
Are there a lot of small objects or kinck-knacks at dog level?
Are living quarters dog friendly?
Is there a yard? If so, what is the condition of the yard?
Is there a fenced yard?
If there is a fenced yard, are thre any areas of gates or fence where a toy dog can slip out or dig under to escape?
Do you see current leashes/harnesses if no fence?
Is there a chain tie outside?
Is there a pool/pond/stream/lake in the yard? If so, how do they plan to keep their animal secure from drowning?
Where will the animal eat - is it a clean area?
What kind of food will the animal eat?
What foods are they currently using for other pets?
Where will the animal relieve itself?
If other animals are present, what is the condition of their teeth?
Where will the animal sleep?
How will the animal get exercise?
Where will the animal stay when left home alone?
Will they allow the animal to have free run of the house?
Will they allow the animal on furniture?
What will they do if the animal becomes very ill?
How will they housetrain?
How/would/do they discipline an animal?
How will they work through behavioral issues?
Current pets (name, type of pet, sex, age, how long owned, where kept)
Are pets well cared for? Are there any signs of neglect or abuse?
What will they do if their current pet(s) and adopted rescue animal don't get along?
If you brought your own dog with you for the home visit, how did they react?
Are there any other concerns or limitations?
Would you personally feel comfortable leaving an animal here? Why?
Did the potential adopters express any concerns about the rescue animal they are applying for?