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HOME CHECK CHECKLIST
Please provide as much detail as possible and use your best judgment.
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* Indicates required question
The name of the person/people I'm meeting with is/are:
*
Your answer
This home check is for (pet name):
*
Your answer
The address I'm meeting the prospective adopter at is:
*
Your answer
Where will the animal sleep? (Check all that apply)
*
With the adopter.
In a crate.
Anywhere indoors.
Other:
Required
Where will the animal stay when no one is home? (Check all that apply)
*
In a crate.
In an enclosed room.
I plan to bring the animal with me to most places.
Other:
Required
Who will have the main responsibility of caring for the pet?
*
The person I'm meeting.
Other:
Where and how often will the animal be allowed to relieve itself? (Check all that apply)
*
Fully fenced yard.
Walks/on a leash.
On potty pads.
Other:
Required
Where & when will the animal be allowed to exercise? (Check all that apply)
*
Fully fenced backyard.
Walks/on a leash.
Local dog park.
Doggy daycare.
Other:
Required
Are any toxic chemicals, poisonous plants, electrical cords, etc. within the pets reach?
*
Yes (Please ask the adopter to correct this before the pet arrives).
No
Other:
What steps will you take or have you taken to "pet proof" your home? (Check all that apply)
*
Hide or cover electrical cords.
Move poisonous plants out of the pets reach.
Move hazardous chemicals to a location not easily accessible to the pet.
Provide mentally stimulating toys or treats for the pet to reduce the risk of chewing something the pet shouldn't.
Not Applicable/The home is already "pet-proofed."
Other:
Required
If applicable, is the fence in good condition, wrapped all the way around, free of holes or areas where an animal could crawl under, and in need of no or minimal repairs?
*
Yes
No
Not Applicable.
Other:
Is the home in good repair & clean?
*
Yes
No
Other:
If applicable, do the animals currently in the home appear well cared for?
*
Yes
No
Not Applicable.
Other:
Is there a doggy/kitty door where the animal can come and go as it pleases?
*
Yes
No
Where will the animal eat its meals and how often? (Check all that apply)
*
Once daily.
Twice daily.
Free feed.
In a crate.
In an enclosed area.
In an open area.
Other:
Required
Will water be provided and easily accessible all day?
*
Yes
No
Name of volunteer completing this form:
*
Your answer
Home check date:
*
MM
/
DD
/
YYYY
**DO NOT ASK THIS QUESTION TO THE PROSPECTIVE ADOPTER**
Based on your experience with the adopter today, do you feel like they would be a good candidate for adoption?
*
Yes
No
Other:
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