Pre-Adoption Home Inspection Form Page 2
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3SECTION C – Family & Other Pets
I. Does the family have children?
YES
NO
If yes, how many and what are the ages?
1. ________________________________ Age ___________
2. ________________________________ Age ___________
3. ________________________________ Age ___________
4. ________________________________ Age ___________
2. Does the family seem happy and committed to the idea of fostering a homeless basset hound?
YES
NO
Notes_______________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________
3. Does the family have other pets?
YES
NO
If yes, list pets here
1. Type _____________________________ Breed _________________________________
2. Type _____________________________ Breed _________________________________
3. Type _____________________________ Breed _________________________________
If ‘No’, skip to SECTION D - Plans for Adopted Dog
4. Are the pets getting along?
YES
NO
Notes ______________________________________________________
5. Are the pets clean?
YES
NO
Notes ______________________________________________________
6. Are pets current on current on vaccinations, including bordetella?
YES
NO
7. Is heartworm preventative and flea/tick preventative on hand?
YES
NO
If so, when is the next dose due? ____________________________________________________________________
Brands preventatives currently used _________________________________________________________________
8. May Suncoast Basset Rescue contact your vet?
YES
NO
Family’s Vet ________________________________________________ Vet’s Phone Number __________________________
Vet’s Address ______________________________________________________________________________________________
9. If pet is a dog, what is the dog fed? _______________________________________________________________________________
10. How often is the dog fed? _______________________________________________________________________________________
11. Are food/water bowls (inside and outside) clean and of adequate size?
YES
NO
12. Is the dog provided with toys, chews, treats, and beds?
YES
NO
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Parent category: Business