HOME EVALUATION FORM
To the Home Evaluator:
Try to get as much information asked for on this form as possible.
Ask questions and get as many details about the home environment
as you find appropriate. Some of the questions on this form
may not apply to a particular home. Try to bring another
Volunteer or friend with you on the home visit, both for
the purpose of having another pair of eyes and ears to assist
you in making a complete evaluation, and for personal safety.
If they don’t currently have pets, try to bring one
of your own dogs so that you may observe their behavior around
Adoption Applicant's Name:
Type of Dwelling:
______ Single family home
______ Garden Apartment
______ Condo Community
______ High Rise Apartment
______ Row House
Setting (circle all that apply):
Highway Frontage/Neighborhood Street/Country Road/City Environment
Property Bordering on Park/Field/Woods
Describe accommodations the home has for a dog and where the
dog will be left when owners are away. For example, crate
in kitchen/laundry room, baby gate across kitchen door, no
crate planned, pen in basement, pen in garage, outdoor run.
Include complete description of any pen or kennel (chain
link run, dirt run with chicken wire, etc.)
Do they intend to ever leave the dog chained or left unattended
in a fenced-in yard?
Describe fencing, if any, and condition/security of fence:
Pay special attention to their behavior, the parents' responses
and method of discipline, and the children's interactions
with other pets. Note whether parents always supervise young
children with other pets, and if the parents seem to expect
the child/children to "be responsible" with the pets.
Observe their general behavior among family members and between
family members and pets - respectful, hectic, loud, quiet,
Other pets: Describe apparent health and well being of other
family pets. Things to note would be skin or flea problems
on other animals, overweight or underweight, type of collar/I.D.
other pets have, etc.
Owner interaction with other pets: Describe the relationship
family members seem to have with other pets.
What role will the dog play in the applicant's life? Are the
other pets treated like family members?
How do the other animals behave?
applicant believe that new dog will "train" old
dog or vice versa?
If applying for a second dog, has applicant ever owned more
than one dog at the same time?
What are the owner's responses to the dog behavior, are they
appropriate? How do the animals react to the owners' response?
Do their current pets obey happily? Or do they seem out of
control and undisciplined? Do they seem to fear any particular
Do the owners appear to know some basic training techniques?
Explain that re-homing a dog is stressful for the dog; that
the rescued dog that they want to adopt may have training
accidents, even if they are housebroken while they are in
foster care, for the first few weeks. Ask the potential Adopter(s)
what would they do or how would they react to their new dog
having an accident?
Please describe anything additional about the home environment
that you feel is pertinent:
Is there anything in general or specifically that would cause
you to feel
uncomfortable about placing a dog in this home? If so, why? "Gut
are considered important!
Would you feel comfortable leaving your own dog with the applicant?
_______Do Not Approve Adoption
_______ Adopt after additional counseling of owners and/or
modifications to the home environment (describe):
Suggestions: If you need to take notes during the visit,
please do so discreetly. It is better for the applicant(s)
to feel at ease with you so that they will “be to be
themselves.” Complete this form after the visit, when
you are not in the presence of the prospective adopter(s).
Qualities to note are sincerity, commitment, tolerance of
normal dog behavior, honest representation of the home environment,
children's behavior with other pets and expected role of children
in pet care.
Obtain explanations about the absence of any family member
during the home visit. Feel free to ask leading questions to
begin productive conversation. Often good conversation will
reveal far more than questions!