Potential Adopter:

• Name:
• Dog of Interest:
• Date of Visit:
• Home Visit Done By:

The Neighborhood:

• Describe the Neighborhood (Suburban, Rural, Urban, Farm)
• Would you consider the street to be high-traffic?
• Would you be comfortable walking in this neighborhood?
• Are their children outside playing in the neighborhood?
• Is there a busy or dangerous intersection nearby?
• Did you notice any other dogs in the neighborhood?

The Home:

• Is the home an apartment, condo, duplex, single family or mobile home?
• When entering the home, are there double doors? Is there an escape risk?
• Are they apt to move? (for sale sign in front yard?)
• Is the home clean? If no, please describe conditions:
• Does the home appear to be dog friendly?(dog hair, beds, toys)
• Where will the dog be kept at night and when no one is home? (baby gate, crate, area of the home)
• Is there a garage?
  • If so, will the dog have access to the garage?
  • Are there any hazardous chemicals (ex: antifreeze) or sharp objects within reach of the dog?
• Is there a basement?
  • If so, will the dog have access to the basement?
  • Are there any hazardous chemicals or sharp objects within reach of the dog?
• Are there any areas of the house that can be damaged by a dog (such as carpeting or furniture)?
  • If so, how do they intend to prevent such damages?