First and Last Name *

Email *

Address(include street name and number, city and province) *

Contact Number *

Do you live in a *

House

Condo

Apartment

Duplex

Townhouse

Do you *

Own

Rent

Live with parents

Other

If renting, please provide landlords contact information

House Setting *

City

Rural

Describe the activity level in your home *

Busy/Noisy

Moderate comings and goings

Quiet with occasional guests

Please list all people living in the household (include name, relationship, gender and age) *

Does anyone in your household have allergies to animals? *

Yes

No

Are all members of your family agreeable to fostering a dog? *

Yes

No

Please list any pets you have (Please include name, breed, age, altered, gender, UTD vaccines, heartworm, etc) *

Would you be willing to have a Team Member call your veterinarian for a reference check? (Please authorize vet to speak with us). If yes, please provide name and contact info *

Are you willing to foster a dog of any age? If not, please give range. *

What size dog are you willing to foster? (check all that apply) *

Small

Medium

Large

Please describe the type of dog you are willing to foster (please include breed, coat length, personality traits, energy level, hypoallergenic) We always want to make sure we have the best fit for our foster homes *

Are you willing to take your foster dog to vet appointments at a convenient time for you? *

Yes

No

Maybe

Are you willing and able to medicate your foster, even if it is just a monthly heartworm preventative *

Yes

No

Maybe

We cannot guarantee a dog to be housebroken, are you equipped to train with love and patience? *

Yes

No

Maybe

Have you had any experience with an emotionally or physically neglected or abused dog? *

Yes

No

Are you willing to use a crate for a dog if recommended? *

Yes

No

Maybe

Do you have a fenced yard? If fenced, please give details on height, material, # of gates, are gates locked or lockable? *

How many hours in a day would the foster be left alone? *

What are your plans to exercise your foster? Please list any parks near by or trails, how many walks a day, approximate length, activities such as agility *

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