foster dog report ...
basset rescue of old dominion, inc.

Dog Name:*    

Dog's Approximate Weight (pounds):     

Foster Parents:*  

Foster Email:*

Foster Home Phone:*

Foster Cell Phone:

1. Heartworm Treatment Details

Date of Last Heartworm Treatment:*

Brand of Heartworm Treatment:  Heartgard Interceptor Sentinel ValuHeart Other (please specify)   Other (please specify):
   

2. Flea Medication Details

Date of Last Flea Medication:*

Brand of Flea Medication:    Advantix Biospot Frontline Hartz Other (please specify)   Other (please specify):
   

3. Has your foster dog had any health problems in the past month (including ear infection, diarrhea/vomiting, skin problems, limping, lumps, etc.)?*

 Yes   No

If veterinary care was required for any of these, please give details below:

4. Has your foster dog shown any behavior problems in the past month (such as housetraining difficulty, barking, escaping, destruction, separation anxiety, etc.)?* 

Yes   No

If Yes, please give details below:

5. Has your foster dog shown any aggression in the past month?* 

Yes   No

If Yes, please give details below:

6. Has your foster dog had any improvements in the past month?*  

Yes No

If Yes, please give details below:

7. What are the good and/or bad characteristics about your foster dog?*

8. Would you say your foster dog is ready to be adopted at the present time?*  

Yes No

If No, please give details below:

IMPORTANT:  You must click on the "SUBMIT Foster Dog Report" button to complete this form!