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Home Visit Form

Date
Month
Day
Year
Doggy Door?
Yes
No
If they have a cat, will the litter box be protected from the dog?
Yes, it will be protected
No, it will not be protected
No cat at the home
Is the yard fenced with no gaps or holes to get out?
Yes
No
Does the gate close properly?
Yes
No
No gate
Is there a lock on the gate?
Yes
No
No gate
Are there Sago palms in the yard?
Yes
No

Any part of this plant, if chewed, is deadly to dogs.

Please check if the yard is free of the following:

Checking a box means the yard is free of that option.

Are there any outside kennels or chains you can see?
Yes
No
Do they own a crate?
Yes
No
If there is a water dish for current dogs/cats, is it clean with fresh water?
Yes
No
No current water dish
Is the adopter prepared for the increased work, expenses, and commotion?
Yes
No
If needed, are they willing to enroll the dog in obedience classES?
Yes, they are willing
No, they are not willing
Obedience class not needed

The dog will need a few weeks to adjust to their new surroundings. Even if a dog is housebroken, it may have a few potty accidents due to stress and being confused. They will need to be patient and understanding until the dog learns the family’s routine.

Would you feel comfortable leaving your personal dog with this family?
Yes
No
Any concerns with this home visit?
Yes
No
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