HOME CHECK - FOSTERER/ADOPTER FORM

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1 HOME CHECK - FOSTERER/ADOPTER FORM Surname Personal Details First Name Age of Applicant Address Type of house Tenant or Home Owner (View tenancy agreement - take photo of any clauses in relation to pets/or make notes about it) How long at present address Home contact number Mobile contact number address Other adults in the home (Partner, Lodgers) and Ages? Are there children in the home? Names & ages of children Occupation & hours worked Do you have any medical/physical conditions that may affect the long term care of the dog?

2 Veterinary Details All Veterinary Issues: Neuters, Jabs etc are to be carried out as per HEART's request Name of Vet Address Telephone number Are you happy for HEART to contact your Vet? Are there other animals in the home? (Please give details) Yes / No Other Animals If there are other dogs in the home are they neutered? If they are not, are they due to be neutered? Or for what particular reason they won t be neutered? Where will the Foster/Adoptive dog be kept during the day? Where will the dog sleep? Home/Routine If the dog is to be left alone; how long would it be left for? Where would the dog be left during this period? Is the garden fully enclosed and secure? What height is the fencing/ walling at the lowest point? Are there any noticeable potential dangers with the garden? i.e. permanent structures near fences etc. Are there areas for walking locally? When you go on holiday who would take care of the dog? Do you have previous experience of Huskies? If not, what knowledge of the breed do you have?

3 Why do you want a husky? As a Husky Fosterer/Owner: Do you know NOT to let your dog off lead? Yes / No (Please explain why) Do you have a dog crate? Yes / No You do understand the dog will require plenty of exercise, regular grooming, training where applicable etc? Some dogs suffer from separation anxiety, which can cause them to be destructive and/or noisy etc. Would this be an issue for you or your neighbours? Do you understand that NO Dog of HEART is to be used for breeding purposes? Are you fully aware that you are responsible for the upkeep of the dog i.e.: food, treats, toys etc? Are you fully aware that whilst you are Fostering for HEART you are required to keep them updated on a regular basis? Are you fully aware that whilst you are Fostering For HEART the dog remains the property of HEART and that the dog can at any time be removed from your home/care by HEART should they for any reason find it necessary to do so for the wellbeing of the dog? Have you fostered before, if Yes who for? If the need arose would you be happy to use one? Yes / No If fostered for another rescue what are the reasons you no longer foster for them? I also agree to notify HEART of any change to my contact details; address, telephone numbers and address. Home Checkers Signature Home Checkers Name (BLOCK CAPITALS)

4 H-E-A-R-T Welfare Foster Liability Form I understand that I agree to take in and foster a H-E-A-R-T dog, whom whilst in my care remains the property of H-E-A-R-T. I also agree and fully understand that at any time H-E-A-R-T can carry out an impromptu visit and if they feel the necessity can remove the dog from my care/home for whatever reason. I agree to care for the dog, feed, walk, train to the best of my ability and understand that under NO CIRCUMSTANCE IS THE DOG TO BE LET OFF LEAD. Whilst under my care I understand that the dog must stay in my possession and not be cared for by anyone else unless pre-arranged with a member of H-E-A-R-T in writing. I agree to foster the dog for as long as is needed to assess the dog safely to work on issues where needed and to prepare him/her ready for their forever home. This may include caring through the neuter process. If for any reason I am unable to carry on fostering the dog I agree to hand the dog back to H-E-A-R-T. I fully understand that by me taking care of this dog that H-E-A-R-T cannot accept liability for damages incurred to my property, myself, members of my family or any other animal that I may own. I also understand that H-E-A-R-T will not accept liability for damages to persons, property and animals sustained outside the fosterers home by a dog fostered on behalf of H-E-A-R-T. ALL vet appointments must be approved by H-E-A-R-T before the dog is taken to the vet, or H-E-A-R-T may not be able pay for this. The dog is not to be used for profit except with written permission from HEART Welfare. Fosterers Name H-E-A-R-T Welfare 194 Bath Road Worcester WR5 3ER heartwelfare@btinternet.com H-E-A-R-T Welfare contact no Two copies of this form are to be completed: One to be retained by Foster and the other by H-E-A-R-T

5 H-E-A-R-T Welfare Foster Liability Form I understand that I agree to take in and foster a H-E-A-R-T dog, whom whilst in my care remains the property of H-E-A-R-T. I also agree and fully understand that at any time H-E-A-R-T can carry out an impromptu visit and if they feel the necessity can remove the dog from my care/home for whatever reason. I agree to care for the dog, feed, walk, train to the best of my ability and understand that under NO CIRCUMSTANCE IS THE DOG TO BE LET OFF LEAD. Whilst under my care I understand that the dog must stay in my possession and not be cared for by anyone else unless pre-arranged with a member of H-E-A-R-T in writing. I agree to foster the dog for as long as is needed to assess the dog safely to work on issues where needed and to prepare him/her ready for their forever home. This may include caring through the neuter process. If for any reason I am unable to carry on fostering the dog I agree to hand the dog back to H-E-A-R-T. I fully understand that by me taking care of this dog that H-E-A-R-T cannot accept liability for damages incurred to my property, myself, members of my family or any other animal that I may own. I also understand that H-E-A-R-T will not accept liability for damages to persons, property and animals sustained outside the fosterers home by a dog fostered on behalf of H-E-A-R-T. ALL vet appointments must be approved by H-E-A-R-T before the dog is taken to the vet, or H-E-A-R-T may not be able pay for this. The dog is not to be used for profit except with written permission from HEART Welfare. Fosterers Name H-E-A-R-T Welfare 194 Bath Road Worcester WR5 3ER heartwelfare@btinternet.com H-E-A-R-T Welfare contact no Two copies of this form are to be completed: One to be retained by Foster and the other by H-E-A-R-T

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