Home Visit Form Who was this home check for?* Foster-to-adopt applicant Foster applicant Adoption applicant Would you approve this home check? Yes No Thanks for doing that home check for us! Did you know that this form is only required if the application was for fostering? You're still more than welcome to fill this form out for adoption applicants if there are more details that you'd like for us to know about, but it's not required for adoption applications. Rescue on!Date of Home Visit* MM slash DD slash YYYY Home Visit Volunteer Name* First Last Potential Foster/Adopter Name* First Last Potential Foster/Adopter Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code About the NeighborhoodDescribe the Neighborhood* Suburban Urban/City Rural/Farm Would you describe this area as high traffic?* Yes No Moderate Would you be comfortable walking in this area?* Yes No Is there a lot of human/dog foot traffic in the area?* Yes No Somewhat The Home and YardDescribe the home:* Single Family Home Duplex Condo Apartment Mobile Home Camper/RV Is the home:* Clean and free of clutter Some clutter but clean Cluttered and dirty Hoarder status Explain if needed:Where will the dog be kept when no one is home?* Where will the dog sleep at night?* Did the home smell of:* Cigarette smoke Marijuana Urine No concerning smells Is there a yard?* Yes No Is the yard completely fenced?* Yes No Is the fence shared with a neighbor?* Yes No What type of fencing?* Wire or Split Rail Privacy fencing 6' 4' Electric or Underground N/A No fence Any concerns with the fencing? Is it dilapidated? Are there low areas to jump over? Areas that a dog could squeeze under? Holes between pickets? Items placed next to the fence that could be used to jump over?*Is there direct access to the yard from the home?* Yes No Is there a doggie door to the yard from the home?* Yes - home to yard Yes - garage or indoor area connected to a run No - No doggie door anywhere Any concerns about areas of the home, yard, pen, garage or anything that the dog will have access to?*In the yard there were:* Dog toys A pool or water feature with a pond Lots of debris - branches/limbs Human toys Garbage or junk Lots of animal feces/unkept A covered patio A dog house The yard seems safe Is the yard shaded?* Yes No Are there dogs adjacent to the property?* Yes - well mannered or non-aggressive Yes - aggressive in nature No dogs in neighboring yards The FamilyDid you meet the entire family?* Yes No If no, explain: Was everyone open and willing to talk to you? Did all members seem to support fostering/adopting?*Were there children at the home visit?* Yes No Were there other animals at the home visit?* Yes No Other animals live in the home, but were out for the home visit. Did the children in the home seem well behaved and polite towards the adults?*Have the children been taught how to behave with a new dog? If there are other animals in the home, were the children appropriate with them?*The family seems willing to handle the following:* House training Crate training Basic obedience Fleas, ticks, worms and other creepy crawlies A special needs dog A destructive dog A dog with anxiety A dog that's not good with cats A dog that's not good with dogs A fearful or timid dog A dog that barks Transport to/from a BBCR veterinarian List all pets in the home:*NameBreedAgeGenderTemperament Please check all that apply to the pets in the home:* Well cared for Overweight or too thin Long toe nails Unkept coat Medical condition not addressed Happy and outgoing Timid or fearful Aggressive in nature (dogs only) In need of obedience training Pets are comfortable indoors Pets are allowed on furniture Pets are not allowed on furniture, but have dog beds Crated N/A No pets in the home Would you feel comfortable leaving your own dog there?* Yes No, but I think it's a good dog home, just not for me/my dog. No Please explain if needed: Additional concerns, follow up items, or things we should know that were not previously mentioned?*Please upload any pictures you may have taken of the foster home. Drop files here or Select files Max. file size: 512 MB. Home Visit Volunteer Typed Signature - By signing below, I certify that I completed the above named home check.* HiddenHome Visit Volunteer - By signing below, I certify that I completed the above named home check.*Potential Foster Typed Signature - By signing below, I comply with all rules and guidelines set forth by Big Bones Canine Rescue Service, Inc and by the state of Colorado via PACFA regulations.* HiddenPotential Foster - By signing below, I comply with all rules and guidelines set forth by Big Bones Canine Rescue Service, Inc and by the state of Colorado via PACFA regulations.*Today's Date* MM slash DD slash YYYY
