HOME VISIT FORM FOR ADOPTERS AND FOSTER HOMES Your Name: Your Email: Applicant Name(s): City, State: WHICH STATE should receive this form? (This is the same team that assigned you the application) AR Adoption Application Screening AR Foster Home Screening FL/AL Adoption Application Screening FL/AL Foster Home Screening GA/LA/MS Adoption Application Screening GA/LA/MS Foster Home Screening MI Adoption Application Screening MI Foster Home Screening MN/IA/SD/ND Adoption Application Screening MN/IA/SD/ND Foster Home Screening NM Adoption Application Screening NM Foster Application Screening NC/SC Adoption Application Screening NC/SC Foster Home Screening TN/KY Adoption Application Screening TN/KY Foster Home Screening TX Adoption Application Screening TX Foster Application Screening Date of Visit: Were ALL household members present? Yes No (Please check the interview and application for household members to be sure you meet them all.) If not, why not? 1
Do the animals in the home match the animals reported on the application and phone interview? Yes No List any unexpected pets. Is there a resident dog(s) in the home? Yes No In what condition do you find the resident dog(s)? Just right, Pudgy, quite overweight. It is important for health that the adopting family be willing to maintain the dog's appropriate weight for good health, and especially if the dog has arthritis or hip dysplasia. The weight can also give us a clue about whether the applicants stated activity level corresponds with the dogs' condition. i.e. a family that states the resident Springer jogs 3 miles a day but is pudgy, might need further education about feeding and exercise. Describe more about the resident dog(s). What type of collar are they wearing? What condition is their coat? Any signs of skin issues/eye/ear problems? How did the dog react to you? Did the dog seem well-mannered or out-of-control? If you brought a guest dog, how did the resident dog(s) interact? How did the adopter/foster applicant react to your dog and vice versa? How was the resident dog's social skills with your dog? Were the people patient, soft, loud, annoyed, heavy-handed, or dog-savvy with your pet or their own? 2
If there were children present, how did the kids interact any resident dogs(s) or pets? How did they interact with your dog, if you brought one? (i.e. Were they calm, ignored the animal(s), wild & crazy, all over the dog, dog-savvy, gentle.) INTERIOR AND SPRINGER ACCOMMODATIONS Describe the condition of the home: (i.e. Immaculate, untidy, cluttered, lived-in but clean. ) What areas of the house will the dog have access to? All of the house or only certain rooms?) This is opportunity to discuss dog might need an adjustment period and may have some accidents. Do they have a crate? Or have baby gates or a room designated for when the dog first arrives and isn't ready for full access? Where will the dog sleep? Please ask to see and discuss this. Where will the Springer stay when they are away from home? How often and how long? Ask to see the space/location and be sure it looks safe. Talk about their exercise plans- how often, how long, where? In your opinion, are the adopters realistically prepared to meet the exercise needs of a Springer? Property and Yard Describe the street and setting. For example: Is it busy, quiet, in-between? Is it rural or urban or a subdivision/development? How far is the house from the road? 3
Describe yard and if it is fenced, describe the height, type, condition, size: Please check the fence and look for any spots that a Springer could get out that they might be unaware of. If fenced, will the dog have access to it via doggie door or would the dog stay out there when they are not home? IF not fenced, ask how to they plan to contain the Springer for potty breaks, and exercise. IF electric/invisible fence, ask about the borders, and training, and if the dog would ever be outside in invisible fencing when they were not home. Some people are unaware that the invisible fencing can fail to secure the dog (even if they did fine for years), and it doesn't keep other animals out. It is not safe to leave the dog out there when the owner isn't home. Is there any water-feature in the yard or otherwise accessible to the dog? Yes No If yes, describe. Would a Springer be welcome to use the water for play and exercise? If yes, what rules will be in place to ensure safety. If not, how will they keep a Springer out of the water? Are there any shaded areas in the yard type (i.e. trees, carport)? Yes No Is there a dog house, dog run, or kennel in the yard? Yes No If yes, please describe AND ask under what circumstances these accommodations would be used. Explain that our rescue Springer in foster care are most used to staying safely in the house, and we often rescue them from outdoor living situations. They may not appreciate staying outside. Are there any possible hazards or challenges in the yard that could pose a danger to a Springer? i.e. chemicals used, toxic plants, alligators, etc. Yes No If Yes, describe. 4
FINAL COMMENTS AND IMPRESSIONS Are there any unique circumstances or concerns to address or things that bothered you about the situation? What type of Springer would fit in well with these adopters? (activity level, age, personality) Are their expectations of an adopted Springer realistic in terms of behavior? (Or are they hoping for a perfect dog?) If this is for a foster applicant: 1) Do you feel that they could adapt to a dog that has never been in the house before? 2) Are ready to deal with housetraining accidents? 3) Can handle doing basic manners training? Comments and overall summary Gut feelings are important. Pour your guts out here! Would you feel comfortable leaving your dog with the applicant? Any feedback on the form? Wording or order of questions? Problems with the form? 5