Potential Adopter:
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?
How would they react to accidents or negative behavior such as chewing?
Where is or will the dog food be stored?
Does anyone smoke inside the house?

The Yard:
Is the yard completely fenced?
      If so, what kind of fencing?
Is there direct access from the house to the yard?
Does the fence appear to be dog proof? (ex: no gaps between house and fence, no broken areas or areas with gaps between fencing or underneath fencing)
Are there any dangers in the yard? (ex: poisonous plants, sharp objects, swimming pool without a safety fence)
If there is another dog in the residence, does it appear that the yard is cleaned of feces regularly?

The Family:
Did you meet all members of the immediate family?
Did any members of the family appear to oppose the adoption?
Are they friendly & willing to talk with you?
Are their children?
Do they act appropriately around dogs? (poking, pulling or yelling at the dog)
Do they understand that if the adoption is unsuccessful that the dog must be returned to BPSBR?

The Pets:
Do they have any other pets?
Did you meet their pets?
Please describe other pets.
Do their pets appear to be in good health? (healthy weight, well groomed, social)
Do they have any outdoor pets?

Other Info:
Are their any concerns, special needs or unusual circumstances we need to consider?
Would you feel comfortable leaving your pet in this home with this family?
Please list any other comments or concerns you may have  after visiting this family.