4ON Dog Virtual Home Visit Form
Thank you for taking the time to do a virtual home visit during the COVID19 crisis. This allows us to get a feel for what dog would fit perfect for you, any trouble areas we can recommend to fix, and to make sure that the dog will fit with your current family members and lifestyle. We ask that all members of the household are present to make sure that the dog is good with all members of the household and that all members are aware/accepting of the fact that you are trying to foster or adopt.
Volunteer Name [if you are not a volunteer skip]
First Name
Last Name
Type of Home Visit
virtual
video/picture
in-person
Other
Applicant Information and Results
Applicant Applied To:
adopt
foster
foster to adopt
Other
Applicant Applied For:
specific dog (put in other option below)
to be put on file in future
Other
Name Applicant Put on Application
First Name
Last Name
Applicant Physical Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Applicant Email
example@example.com
The Family
ALL HOUSE MEMBERS NEED TO BE LISTED:
Person 1
Person 2
Person 3
Person 4
Person 5
Name
Age
Email
Phone(Emergency)
Did you speak with the entire family/entire family present?
Yes, great
No, weird
Yes, not so great
No, need to
Do they seem to have realistic expectations of pet ownership?
Yes, great
No, weird
Yes, not so great
No, need to
Describe the overall tone of the home:
loud
hectic
calm
respectful
silly
other
Are there children regularly in the home?
yes
no
sometimes
not frequently
Did anyone seem opposed, hesitant, or unhappy about getting a pet?
yes
sort of
no, not at all very happy
rude and uncaring
The Neighborhood
Describe the Neighborhood
Suburban
Rural/Farm
Urban/City
other
Are they / would you feel comfortable walking the area?
yes
no
other
Is there are busy intersection near the home?
yes
no
other
Do they share a fence with the neighbors or any common spaces?
yes
no
other
Is it a high traffic street?
yes
no
other
Neighbors Have the Following:
dogs that run the fence line or free roam
fence that is tied in to applicants'
roaming cats
friendly dogs
House and Property Information
The Home is the Following:
Sanitary and pet friendly
Apartment/MFD
house/SFD
duplex
condo
manufactured
rented
owned
single-story
multi-story
Home has the following:
garage - no access for pet
garage - full access for pet
basement
swimming pool
steps and stairs
doggie door
The Yard is the Following
fully fenced in - privacy
fully fenced in - non privacy
dog-safe
has direct access to the house
no yard
worn areas
What kind of fence and yard do they have?
Any concerns about the yard, home, or neighbors below:
any extra notes about the yard please put here like old tethers, old shock collar fencing, fencing falling apart, lots of debris, no shade, neighbors dogs
Is there a dog park located nearby? We do not support dog park play -- so please keep a note
Do you feel as if this home is safe for said dog? If not, why?
Current Pets
Please list all current pets or pets that visit; Did they look clean, well fed, friendly? Add any additional information here about pets
Are the pets kept indoors? Any sign of chains, tethers, shock collars, worn areas in the yard, outside pets, etc.?
Media Proof of Home Visit for Review
Please upload your home checklist if you completed one; If you prefer to just fill out this form fully please skip.
Upload File(s)
this is for the checklist file(s)
Cancel
of
Please upload your home video/pictures of inside
Upload Files
home video of inside (if this is the entire home that is fine too)
Cancel
of
Please upload your home video of front yard / side yard facing road first
Upload Files
home video of road and front / side doors (if you submitted the entire video already skip this one)
Cancel
of
Please upload your home video of outside / fences
Upload Files
home video of outside/ back yard (if you submitted the entire video already skip this one)
Cancel
of
The Family and Home
How will the family allow for proper decompression [2 week shutdown and adjustment period] for their new dog?
Do you feel like they would make great pet parents? If not, why?
Are there any special needs, unusual circumstances or concerns we need to consider?
Additional Notes / Info you would like to share about the family, home, etc. to help us figure out the best fit dog for the family [ like their preferences in a dog]:
Do you feel like this would be the best fit home for this dog? If not, what kind of dog do you feel would be better suited?
Please sign that you have filled out this form to the best of your knowledge and that all of the house members agree(d) to follow the 2 week shutdown and give an underdog a chance for the first few weeks.
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