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Home Visit Report

Home / Home Visit Report

Home Visit Report

Name of Applicant*
First Last
Applicant Email*
Applicant Phone*
Insured's Address
Street Address City State Zip
Date of Home Visit*
MM slash DD slash YYYY
Name of Volunteer Completing Home Visit*
This home visit was completed for a*
- Potential adopter
- Foster volunteer
Dog name*
About the Family
Are all family members present as requested by you?*
- Yes
- No
Please explain why family members are absent.
Did you know this family before doing this home visit?*
- Yes
- No
What is your relationship to this family?*
Do they seem to understand the needs of the breed, and the special care required for brachycephalic breeds?*
Do they seem to understand this particular dog’s special needs, if any (medical, behavioral) and the cost associated with the special needs?*
This may include spine issues, allergies, not being able to have another dog or cat, not being able to have children around the foster or adoptive dog. Do they know how to identify when the dog is having medical issues such as spine issues?
How do they plan on dealing with this particular dog’s special needs?*
i.e. (1) if they don’t like kids and friends come over with their children? (2) if the dog has spine issues, will they put baby gates, so the dog doesn’t climb stairs and lift them up on the couch?
What is the plan for the dog when they are vacationing?*
What is the plan for the dog when they are not home?*
How long and often will the dog be left home alone?*
Will they have a dog walker or doggie daycare?*
- Yes
- No
Please describe.*
Did anybody in the family seem hesitant about having this dog in their home?*
- Yes
- No
Please explain.*
Yard / Outdoor Space
Does the home have a yard?*
- Yes
- No
Where do they plan on walking the dog and how often?*
Is the yard fenced?*
- Yes
- No
Please walk the entire fence and check for any possible escape routes where the dog could get out. Please explain that dogs needs to be supervised even when in a fenced yard as many accidents have happen when dogs have been left unsupervised in fenced yards.
Please describe type of fence and the fenced area.*
Is there a balcony or deck?*
- Yes
- No
Please inspect the railings to be sure the dog can’t slip through the railings or fall off the balcony.
Please describe balcony or deck area.*
Is there a pool?*
- Yes
- No
Is the pool fenced off or in an area that cannot be accessed by the dog?*
- Yes
- No
Is there a pool security system in place?*
- Yes
- No
Please describe the pool area.*
Is there a pond or other body of water on the property?*
- Yes
- No
Is it fenced off or in an area that cannot be accessed by the dog?*
- Yes
- No
Resident Pets
Does this home have any resident pets of any type?*
Please include dogs, cats, birds, reptiles and small animals.
- Yes
- No
Check all types of pets that currently reside in the home.*
- Dog
- Cat
- Bird
- Reptile
- Small Animal
- Other
Please list all pets in the home including type of pet, age, breed and gender.*
Do resident pets appear healthy and well cared for (not over or underweight)?*
- Yes
- No
Please explain.*
Do resident pets have any health issues?*
- Yes
- No
Please explain.*
Do resident pets appear to have any behavior or aggression issues?*
- Yes
- No
Please explain.*
Discuss potential interactions between resident pets and the new dog they want to bring into the home. Explain the importance of slow introduction which may include separation at first.
How does the family feel the resident pets might they get along with the dog they want to bring into the home?*
What is the plan to keep the cat food and litter away from the dog?*
About the Home
Please describe the home in general.*
i.e. warm and comfortable? Overly clean and meticulous? Messy and hazardous? Strong odors? (Smoke)
What type of neighboorhood is the home in?*
- Rural
- Suburban
- City
Do you feel the foster or adopted dog will be happy in this type of setting?*
- Yes
- No
Are there screens on the windows to prevent a dog from jumping or falling out?*
- Yes
- No
Do screen doors close fully and properly so that a dog can’t push it open and escape?*
- Yes
- No
Do they have central air conditioner or window air conditioner?*
- Yes
- No
Do they keep the home at a comfortable temperature?*
- Yes
- No
Were there any strange odors or the smell of smoke in the home?*
- Yes
- No
Please Explain*
Do they have a basement?*
- Yes
- No
Is there a door to the basement to prevent the dog from going in the basement?*
- Yes
- No
Are there any hazards in the basement?*
- Yes
- No
Please explain.*
Is there an attached garage?*
- Yes
- No
Is there a door to prevent the dog from accessing the garage?*
- Yes
- No
Where will the dog sleep?*
Where will the dog stay when no one is home?*
Do they live on a busy street?*
If so, please educate them on the need for securing their dog so they don’t get hit by a car.
- Yes
- No
Do you feel the dog would be safe in this neighborhood?*
- Yes
- No
Conclusion
Do you feel this family would provide an excellent home or foster home for the dog?*
Is there ANYTHING that doesn’t seem "right" about this family or the home? If so, what?*
Would you feel comfortable leaving your own dog(s) in their care?*
Do you have any additional comments or concerns about this family?*

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Home Visit Report

Home Visit Report

About the Family

Yard / Outdoor Space

Resident Pets

About the Home

Conclusion