Home Visit - Suncoast Basset Rescue

Date of Inspection

Name of Suncoast Basset Rescue Dog Interested in #1 *

Name of Suncoast Basset Rescue Dog Interested in #2

Name of Family: (All Adult Members)*

Address:*

City:*

State:

Zip Code:

Name of Apartment Complex*

Primary Phone Number*

Secondary Phone Number*

Work Phone Number

Email*

SECTION B – House, Living Conditions, Yard, and Neighborhood*

House

Condo

Apartment

Mobile Home

Residence *

Own

Rent

Is home in good condition, clean & neat?*

Yes

Are the living quarter’s dog friendly? (medications, etc. out of reach)*

Yes

Does the home have central heat/air and adequate ventilation?*

Yes

If no what type of cooling/heating/ventilation systems are in place?

Is the yard fenced?*

Yes

If yes, what type of fence?

Is fence secure, free from holes, gaps, and weaknesses?*

Yes

If no, please provide explanation:

If not fenced (Check boxes once complete):*

Discuss the importance of leash walks and exercise

Remind to never let dog have free roam outside

Is there a doggie door?*

Yes

Is there a hot tub, pool, canal, or other water area*

Yes

If yes, is dog adequately protected from entry into the hot tub, pool, or canal?*

Yes

SECTION C – Is the main caretaker physically able to care for the dog?*

Yes

Do all adult family members appear to be interested/ excited about adopting a basset?*

Does the Family Have Children? If Yes, How Many and How Old?

If No, do they have young children visit?

Yes

If yes, do they understand the need to watch the children and dog interact, some dogs aren’t comfortable around children?

Yes

Is family interested in fostering? If so do they seem happy and committed to the idea of fostering a homeless basset hound? (If yes, have them complete Foster Care Agreement)*

Yes

Does the family have pets? (If no, skip to SECTION D)*

Yes

List Pets Here (Type-Breed-Age)

If pets are farm animals, do they appear healthy? Sometimes dogs may not be familiar with farm animals.

Yes

Are the pets getting along? Yes or No, Provide Explanation if Needed

Are the Pets Clean?Yes or No, Provide Explanation if Needed

Are the Pets current on vaccinations?

Yes

Are the pets current on heartworm prevention?

Yes

May Suncoast Basset Rescue contact your vet?

Yes

If yes, please provide VET info here:

VET’s Number

How often is the dog fed?

Where is the dog fed?

Are food/water bowls (inside and outside) clean and of adequate size?

Yes

SECTION D – Where will the adopted dog be kept during the day?

Outside, in fenced area

Inside, free roam of house

Inside, crated

Inside, confined to certain room(s)

Where will the adopted dog sleep? (Check one)

Outside, in fenced area

Inside, free roam of house

Inside, crated

Inside, confined to certain room(s)

Is there adequate shelter and water available always?

Yes

If crate is to be used, is it adequately sized and in good condition?*

Yes

SBR Volunteer, explain the following:*

Inform family that adoption applications and pre-adoption home inspections are approved by Suncoast Basset Rescue. SBR will contact the family regarding this inspection and the pending adoption.

Recommend twice daily feedings. Remind the family that some rescue dogs may be a bit malnourished and will need to be fed more food, more often, and in some cases, higher calorie food such as puppy formula, until sufficient weight is gained.

Importance of bathing, nail trimming, and ear cleaning.

Importance of scheduling a vet visit within 30 days of the adoption.

Telephone Suncoast Basset Rescue immediately if the adopted dog becomes lost or is stolen.

Notify Suncoast Basset Rescue at least one week prior to a change of address.

Do not transfer the ownership of the adopted dog to any other person without first obtaining the adoption approval of Suncoast Basset Rescue. The adopted basset may not be transferred to any other person, firm, corporation, or organization for any reason.

If custody of the adopted dog must be relinquished, notify Suncoast Basset Rescue immediately to arrange for its re-adoption.

Recommend that the SBR red tag remain on dog.

Check boxes off once completed

SECTION E – Comments Any special needs, unusual circumstances, or concerns we should consider?

Would you feel comfortable with SBR adopting to this family?

Any other general comments?

Name of Volunteer

Home Visit Form

Foster Homes Desperately Needed!

Owner Relinquishes

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