Sitter Feedback Form
Complete this form following each Sitter assignment, including Weekend Sitting for dogs raised in prison facilities.
Dog's name
*
Your name
*
First Name
Last Name
Email
*
example@example.com
Start date
*
-
Month
-
Day
Year
Date
End date
*
-
Month
-
Day
Year
Date
If this dog was received from a prison, please select the facility.
Please Select
Sandstone
Waseca
Rochester
Stanley
Jackson
Interactions with People
Let us know who the dog interacted with in the home.
*
Adult males
Adult females
Children 10-18
Children 2-10
Babies or toddlers 0-2
Other
How does this dog behave around people in the home?
*
Social
Calm/Neutral
Shy, then warmed up
Shy or reserved in general
Excited- jumped on people
If this dog seemed shy or hesitant around any people in or around your home, please provide as much detail as you can.
*
Include a description of the person, the surroundings and the dog’s reaction and recovery.
If this dog seemed afraid of, growled or barked in or around your home at anyone, please provide as much detail as you can.
Include a description of the person, the surroundings and the dog’s reaction and recovery.
Comments about interactions with people?
Interactions with Resident Pets and Other Animals
Tell us what pets you have.
*
No personal pets
Dog(s)- large breed
Dog(s)- small breed
Cat(s)
Rabbit(s)
Bird(s)
Reptiles(s)
Small animal
Large animal (outdoor)
Other
How did this dog behave around your pets? Check all that apply.
*
Playful
Peaceful/Neutral
Respectful
Too Excitable
Obsessed
Submissive
Shy
Fearful
Did not respect boundaries
Bullying/Controlling
Other
Please describe the typical behaviors that were not playful, peaceful or respectful.
If you have other animals such as chickens, horses or pigs, let us know how the dog behaves towards those animals.
How does this dog react to any wildlife such as birds, rabbits or squirrels?
*
Fine/uninterested
Interested
Barking
Chasing
Obsessed
Other
Comments on reaction to wildlife?
Behavior at Home
Let us know if you saw any of these behaviors. Check all that apply.
*
Tested rules at first, then respected
Tested rules continuously
Very busy, needed to be kenneled to rest
Chewed inappropriate items
Picked up everything
Mouthed people’s hands, arms or clothes
Stole items and brought them to me
Stole items and played keep away
Counter surfed/scavenged
Attempted to get on furniture
Overly excited at door
Attempted to push through doors
Begged for food
Vocalized (alert or demand barking)
Vocalized (at ambient noises or through windows)
Marked purposely in home
Urine accident in home
Bowel movement in home
Other
Please provide detail on any behaviors noted.
Did the dog display any hesitancy with stairs or surfaces in your home?
*
Yes
No
Please let us know what the dog did and if they were able to recover.
*
Did the dog display any stress signs, hesitancy or aversion to your vehicle or riding in the vehicle?
*
Yes
No
Please let us know what the dog did and if they were able to recover.
*
Select any of these exposures the dog experienced in your home.
*
Umbrella
Vacuum cleaner
Mirror
Broom/mop
Hair Dryer
Door slamming
Kids’ toys
Sports equipment
Garbage/recycling bin
Ceiling fan
Garage door
Reclining chair
Rolling chair
Small appliances
Large appliances
Wind chimes
Clapping hands
If the dog had reactions to any of the selected exposures, please let us know what the dog did and how they recovered.
Tell us how the dog behaved in the kennel. Check any that apply.
*
Calm
Entered on cue
Needed to be bribed to enter kennel
Stressed (panting, circling, digging)
Whined
Barked
Hid in kennel
Other
If the dog seemed stressed or vocalized in the kennel, what was done to prevent the behavior and how long did it take the dog to recover?
*
Loose Leash Walking
Tell us about where you practiced walking with the dog
*
For example, around the neighborhood; urban setting; country roads; parks.
What equipment do you use? Select all that apply.
*
Collar Only
Halti Head Collar
Gentle Leader
No Pull Front Clip Harness
Tell us how effective the equipment was.
*
Walked nicely on collar only
Walked nicely with head collar or harness
Pulled even with head collar or harness
Dog avoids equipment/getting dressed
Dog freezes/refuses to move in equipment
Other
What types of behaviors did you notice on walks? Check any that apply.
*
Picked up and chewed objects
Picked up and ingested objects
Sniffed occasionally
Sniffed excessively
Barked or growled occasionally
Barked or growled excessively
Lunging at other people
Lunging towards other dogs
Lagged behind handler
Rubbed Head Collar
Distracted often but focused with reminders
Distracted the entire time, would not focus
Pulled the entire walk
Pulled occasionally but would come back to handler
No pulling and walked nicely
Focused on handler
How would you rate this dog's loose leash walking skills?
*
Please Select
1 - Hard to handle, pulled excessively, very distracted
2 - Needed reminders to walk near me, distracted or pulled occasionally
3 - Only needed occasional reminders to walk close, hardly pulled
4 - Walked nicely for rewards, focused, only pulled once or twice
5 - Walked perfectly, very focused, no pulling
Choose the option that most closely represents your impressions.
Comments on loose leash walking behaviors?
Common Cue Response
Sit
*
Please Select
Performs consistently
Performs most of the time
Performs occasionally
Needs improvement/does not know
Please select the best representation of the dog's understanding of the cues.
Down
*
Please Select
Performs consistently
Performs most of the time
Performs occasionally
Needs improvement/does not know
Please select the best representation of the dog's understanding of the cues.
Go Mat
*
Please Select
Performs consistently
Performs most of the time
Performs occasionally
Needs improvement/does not know
Please select the best representation of the dog's understanding of the cues.
Kennel
*
Please Select
Performs consistently
Performs most of the time
Performs occasionally
Needs improvement/does not know
Please select the best representation of the dog's understanding of the cues.
Get Busy
*
Please Select
Performs consistently
Performs most of the time
Performs occasionally
Needs improvement/does not know
Please select the best representation of the dog's understanding of the cues.
Name response/Come (inside)
*
Please Select
Performs consistently
Performs most of the time
Performs occasionally
Needs improvement/does not know
Please select the best representation of the dog's understanding of the cues.
Name response/Come (outside)
*
Please Select
Performs consistently
Performs most of the time
Performs occasionally
Needs improvement/does not know
Please select the best representation of the dog's understanding of the cues.
Comments on Common Cue Response?
Overall Impression of the Dog
Please rate this dog’s energy level. *
*
Please Select
1 - Very Low. Sleeps often, can be difficult to sustain for exercise or training
2 - Low. Rests throughout the day, easy to maintain exercise and training requirement
3 - Average. Rests as needed during downtime but requires moderate exercise and training
4 - Above Average. Does not rest or self-entertain during downtime, requires exercise and training several times a day but easy to manage
5 - High. Busy and demanding of attention. Difficult to manage exercise and training time requirements.
Choose the option that most closely represents your impressions.
How much work was it to care for this dog?
*
Please Select
1- Very easy to have, perfect fit.
2 - Easy to have, little management, and overall good fit.
3 - Some management and effort
4 - Required extra effort, difficult to manage
5 - Exhausting. Too much work and too much to handle.
Choose the option that most closely represents your impressions.
Would you host this dog again?
Please Select
Yes
No
Maybe
Is there anything else you’d like us to know about your time with this dog?
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