Home Evaluation Form printable pdf download

Home Evaluation Form

HOME EVALUATION FORM

Print Name Visited: ________________________________________________________________

Address: _________________________________________________________________________

Phone: _____________________________________ Email: _______________________________

Volunteer Name Printed: ___________________________________________________________

Volunteer Phone: ______________________________ Volunteer Email: _____________________

Date of Home Visit: _______________________________________________________________

How were you greeted? Warmly: ______ Excited: ______ Calmly: ______ Reserved: ______

Indifferent: ______ Irritated: ______

Which family members were present during your visit? Husband: ______ Wife: ______

Other Adults Living in the Home: ______ Children (how many & ages): _____________________

Is there a fenced yard? ________ Size: _________ Material: ______ Secure/Escape Proof?

____________

If a pig or other pets currently reside:

Is there housing for weather protection? _______

Is there a pool to cool off in the summer? ________

In winter, how are pigs kept warm and free from wind/rain/snow? _______

Are there holes or weaknesses in the fence?

How do the pets interact with their owners?

Do other pets appear healthy, well cared for, clean, optimal body weight, spayed/neutered?

Are the premises clean and well maintained?

Other pets in the household, please list: ____________________________________________________

Where will the pig spend the majority of his/her time? __________________________________

Where will the pig sleep? _______________________________________

Home Evaluation Form