Mutley's Miracles

Home visit worksheet

Suitability of Home to Dog: Safe atmosphere for the dog they are considering?
Type of neighborhood: Urban______ Suburban_______ Rural_______
Type of home: Single-Family________ Duplex________ Apartment________ Mobile
Home________
Does applicant: Own_________ Rent_________
If renting, does applicants landlord approve of pets? __________ (Ask to see documentation
that pets are allowed!)
Type of street: Busy/Dangerous_________ Quiet _________ In-between________ Country
road_________
Is there a homeowner's association?________ If so is the dog they are considering
acceptable?__________
Fencing: Is the yard escape proof and cared for?
Is there a yard? __________
Does the exterior of the home look well-cared-for in appearance?_________________
Fenced yard? _________ Fence Type ________ Height ________ Holes, gaps? ________
Gates secure?_______
Actually push on the closed gates (top and bottom) and push on the fence. It may look good,
but the dog will be testing it.
Is the yard: Fully fenced (all the way around the house)________ Backyard only________
Side yard only________
Is there material stacked against or close to fence that will enable dog to jump or climb the
fence?_______________
Outdoor Hazards: Existing pets are familiar with hazards that a new pet will be curious about.
What could a curious dog get into?
Is there a pool?________ In-ground _________ Above-ground _________
Is the pool separately fenced and gate secure?__________________________________
If the pool is accessible, is there an easy way for the dog to get out?_________________
Will the owner be able to teach the dog how to get out? _________________
Are there any dogs in adjacent homes or yards? ___________ What types of dogs?
__________________________ How many dogs?__________ Other animals?__________
What kinds?____________________________________
Is there a possibility of fence fighting?______________, Can the owner stop it, if it occurs?
______________________________

Other pets and family: How does the family relate to the other pets in the home? Are the pets
relaxed and happy?
Does the applicant have any other pets?
Dogs (type, how many)_________________________________________
Cats (type, how many)_____________________________
Other animals (types, how many)___________________
Can the family handle the other pets easily?______________
Are the pet happy being handled, relaxed, and confident? _____________________
Do you get the impression the applicant understands that the dog MUST be leash-walked and
supervised when allowed outside fenced yard?_________________________________
Describe any concerns for the dog's safety and happiness if placed in this
environment._______________________
____________________________________________________________________________
_________________
Did you meet all family members? ________ Any young children?_________ Elderly or
disabled?_______________
Does applicant understand the necessity of supervising pets when around young children?
_____________________
Did you get the impression that anyone in the family is opposed to adopting this pet?
_________________________
How do children in family behave towards other family members and pets?
_________________________________
Is there evidence of tension in the family?_____________________
Yelling? _______________________
Is applicant in the process of moving or considering a move? (For Sale sign in
yard?)_________________________
The home: Will the pet be comfortable and safe and will the family be happy with the pet?
Overall condition of the interior of home: Neat/clean________ Messy_________
Dirty_________
If the family is not conscientious with their home, will they be conscientious in caring for their
pet?
Is there cat food out? ________ If so, how will applicant prevent dog from eating cat food?
____________________
Litter box protected from dogs? __________
Where will the dog spend most of its time? ________
Does the area appear suitable?________________________
Is there a place to locate a crate for the dog where it can be easily removed from an outside
door during a fire?_________
Where will the dog stay when no one is at home?
_____________________________________________________

What are the applicant's opinions/experience with crating? ____________ Do they have a
crate?________________
If applicant has a crate for dog they are adopting, is the size appropriate for the dog?
_________________________
What type of bedding will the dog have in crate?___________________________
Is food and water set up for the dog inside the crate with the door open?
Show them how to turn a crate into a table if necessary.
Are there any concerns for an elderly dog? ____________ Steps to the yard? _________
Sleeping area? ________
Is home carpeted? _____________ Tiled or hard-surface floors?
_________________________________________
Are there things left laying around that they will not want the dog to ruin (clothes, papers,
cords)?__________
How will they keep the dog from bolting out the front door?____________________
Training and Responsibilities: Who is responsible for the dog?
Are they willing to attend a formalized obedience course or consult a private trainer if
necessary?_____________________________________
Who will exercise the dog?________________________
Who is primarily responsible for the daily care of the dog?__________________
Is the family aware of shedding?_________ Will it present a problem with
environment/allergies?________________
Does the applicant or family members have any special needs or challenges?
_______________________________
What is the applicant's dog training experience?
______________________________________________________
How would they correct misbehavior?
______________________________________________________________ Barking?
___________________ Biting? ___________________ Accidents in the house?
____________________ A dog fight? ________________ Noise shyness such as fireworks or
thunder? _____________________________
Are they willing to give the new dog several weeks to acclimate to their environment?_____
Does the home seem to "fit" the dog?_______________
Were there any training or behavior questions that you couldn't answer which need a follow
up?
Use additional space to describe your visit and note any other items, areas that need
education, fence needing repairs, or other
concerns:____________________________________________________________________
_____
____________________________________________________________________________
_________________
____________________________________________________________________________