German Shepherd Dog Rescue of Georgia Home Visit Evaluation
Evaluator
*
First & Last Name
Evaluation Date
-
Month
-
Day
Year
Date
Applicant
*
First & Last Name
Applicant Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Applicant Phone Number
-
Area Code
Phone Number
Applicant E-mail
*
Does the home provide a safe place for the rescue dog to reside?`
Yes
No
Comments
Are there more than two small children in the home?
Yes
No
Comments
Are there other pets in the home? If so what?
Yes
No
Comments
If there are other dogs, are any chained or tied outside?
Yes
No
N/A
Comments
Is the home clean and adequately furnished?
Yes
No
Comments
Is the home located near a highway?
Yes
No
Comments
If so, is there a securely fenced yard?
Yes
No
Comments
If the home is an apartment, does the lease allow dogs?
Yes
No
N/A
Comments
If so, are there any restrictions on the size or type of dogs?
Yes
No
N/A
Comments
Will the dog be left alone due to work schedules? (# of hours)?
Yes
No
Comments
In your opinion, is the home safe for a rescue dog?
Yes
No
Comments
Additional comments or observations?
Yes
No
Comments
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