Keep Them Home Application

UTH's Keep Them Home™ program

Keep Them Home (KTH) provides support to you and your family to keep your animal in a safe and loving home and out of the shelter. Through this program, we offer rehoming services, temporary fostering care, and low-cost behavior and training support.

PEOPLE INFORMATION
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
I have a permanent address*

YesNo
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I am interested in the following programs:*

Home to home rehomeTemporary fosteringSliding scale behavioral help

HOUSEHOLD INFORMATION
List all other animals in your home, including species, age, breed, sex and whether they are spayed/neutered. (e.g. Rover, dog, 2 years, lab mix, male, neutered)
List all other people in your home, including age and whether or not they will be involved in training. (e.g. Brianne, 5 years, yes)

MEDICAL INFORMATION
Date of last vet visit (if none or unknown, leave blank)

MonthDayYear
{animalName} is up to date on vaccines.*

YesNoUnknown
Does {animalName} have any medical concerns? Allergies? Medications that they are on?
All KTH program participants must be spayed/neutered, microchipped and up-to-date on vaccines. Would you need UTH's help with this?*

YesNo

BEHAVIOR EVALUATION
These questions relate to {animalsName}'s behavior. This will help us ensure that we can come up with the most successful plan for {animalName}'s comfort. Please be honest when answering these questions. We know it can be difficult, but the more information we have, the better chance of a successful future for {animalName}.

Please fill in any known history {animalName} has with these general categories. 'Yes' indicates that they generally do well with this category. If marking "Complicated", please provide more detail below.*

	Yes	No	Unknown	Complicated
Small Dogs
Medium/Large Dogs
Cats
Kids 8 and under
Kids between 9-16

Include any relevant details about the above answers:

Please fill in the severity level for the following issues:*

	Severe	Often	Sometimes	Rarely	Never	N/A
Destructive behavior
Doesn't like strangers
Conflicts with humans in the house
Conflicts with other animals in the home (same species)
Conflicts with other animals in the. home (different species)

Include any relevant details about the answers above:
Has {animalName} ever bitten anyone?*

YesNo
Did {animalName} break the skin?

YesNo
Has {animalName} ever been in an injurious fight with another animal? (one or more animals received puncture wounds or had to go to the vet)*

YesNo
How many times?
What training have you done with {animalName}*

Puppy classesBasic obedienceAdvanced obedienceRegular play group/dog park visitsPrivate lessonsPunishment (squirt bottle, loud noises, etc.)Self trainedLeash corrections ("leash pops")Positive reinforcementClicker (mark/reward) trainingFood/treatsE-collar (shock/bark collar)Other
Please provide any other relevant information related to the behavior problems that {animalNames} in your home.

TEMPORARY FOSTER/DAYCARE INFORMATION
We know that everyone needs some support at times and we don't want temporary living situations to keep you from being able to keep {animalName} with you. We help our community's animals by providing temporary fostering situations for them while their families get back on their feet.
Dates that {animalName} will need temporary fostering:

(If you don't have exact dates, provide a rough estimate)
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
To qualify for our temporary fostering program, you must have a plan in place for being able to take your animals back and provide a safe home for them. Until They're Home prioritizes applications that have the support of a case worker or advocate from an organization working to support the human.
I am working with a human-centric organization to help get into housing or otherwise support my ability to take your animal back.*

YesNo
Name of the organization
Name of contact at the organization
Phone Number
Please enter a valid phone number.
Email
example@example.com
Describe your plan for being able to provide care for {animalName} after the temporary foster period is up.

OTHER INFORMATION
Next Steps

After we receive your application, someone will reach out to you within 48 hours. If you haven't heard from us within that time, please email info@untilhome.org or leave us a voicemail at 720-893-0504.
Temporary Foster

We are a foster based rescue, so we can only take animals into our temporary foster program if we have a foster home for the agreed upon time frame. After they are accepted into our program, we will post your animals to our foster network and reach out directly to any of our fosters who we think might be available. Our ability to take {animalName} into our care is entirely dependent on finding them a suitable foster home.

If you have friends or family that are able to help provide support during the time the animals are in our care, please provide us with that person's information.

While {animalName} is in our care, we have you sign a temporary surrender agreement with a specific end date. If you do not pick up {animalName} by the agreed upon date, we will contact you to either extend the contract or have {animalName} surrendered to us. If we cannot get a hold of you, {animalName} legally belongs to UTH and we will move forward with adoption or other placement.
Behavior/Training Help

All of our behavior and training services are sliding scale fee. If you can afford it, we ask that you give us a donation ($0-$70) to help provide help for the next applicant. Our primary goal is to keep animals in safe, loving homes and we won't turn anyone away because of cost or our services.

After any appointments that you have with our KTH training program, we ask that you visit https://untilhome.org/donate if you are able to make a donation.
Home to Home rehoming

If we have a spot in our foster network open up before your {animalName} gets adopted, we will let you know and offer to take him/her. Please let us know if you need help keeping {animalName} safe and healthy during this time. We offer training and supplies, including baby gates, crates, Xpens, muzzles etc. while you are waiting.

When we get an approved applicant for {animalName}, we will contact you to schedule a meet and greet. If the meet and greet goes well, {animalName} may go on his/her two week trial to adopt period, if appilcable. During that time, be prepared for {animalName} to come back to your home if it is not a good fit. If after the two weeks are up, your animal's suiter chooses to finalize, we will notify you that {animalName} has been adopted.
Signature

I, {name}, understand that Until They're Home (UTH) makes no guarantees about any behavior modification results. I also understand that animal behavior can be unpredictable and I will not hold UTH responsible for any damages incurred by my animal.

I also understand that this is only an application and UTH's ability to help is constrained by the resources that are available, including foster homes and funds available for animal care.
Applicant signature: *

Clear
Signature date*

MonthDayYear
Date
How did you hear about us?*
How did you hear about us?
Should be Empty:

UTH's Keep Them Home™ program

Dates that {animalName} will need temporary fostering:

Next Steps

Temporary Foster

Behavior/Training Help

Home to Home rehoming

Signature