house visit report ...
basset rescue of old dominion, inc.

GENERAL INSTRUCTIONS: Before you go on the house visit, be sure to have a copy of the Application, Contract, Child Waiver (if appropriate) and Disclosure Form with you. Once you have filled out all responses that apply, please click on the Submit House Visit Report button at the bottom of this form to complete the process.
PART I - PERSONAL INFORMATION  Date of House Visit:*
Applicant's First Name(s):* Applicant's Last Name(s):*
Applicant's Street Address:*
Applicant's City:* Applicant's State:* Applicant's Zip:*
Applicant's Home Phone: Applicant's Work Phone: Applicant's Cell Phone:
Applicant's Email:

PART II - THE FAMILY
ABOUT THE FAMILY* (please summarize in text box below)
 (1)  Please list the names (if children, ages; or relationship to adopter - roommate/parent) of everyone who was present during the house visit.
 (2)  Does it appear that all members of the family/household (don't forget roommate, parent, semi-live-in friend) are committed to adopting a basset hound? If no, explain.
 (3)  Are these people young, middle-aged or seniors? Do they have the physical ability to exercise the dog(s) particularly if there is no fenced yard?
 
 
EXPERIENCE WITH AND RESPONSIBILITY FOR DOGS* (please summarize in text box below)
 (4)  If you brought your own dog to the house visit, please comment on how the applicants interacted with the dog - especially the children and other animals in the house.
 (5)  Are they experienced dog owners (owned dogs before) or are they novice dog owners?
 (6)  In your opinion, do they seem like responsible dog owners?
 
PLANS FOR MANAGING THEIR DOG* (please summarize in text box below)
 (7)  Where do they plan to keep the dog while they are away from home (while at work or out for family activities)?
  • Crate
  • Kitchen
  • Run of the house
  • Fenced yard
  • Tied outside on a line
  • Outside kennel
  • Other (please describe) 
 (8)  If gone for long hours during the weekday and they do not have a doggie door, what arrangements have they considered for letting the dog out during the day for breaks (e.g., dog walker, come home for lunch, neighbor, etc.)?
 (9)  If the applicants have children and if they live on a busy street, how will they prevent the children from opening the door and accidentally letting the dog out (if not into a fenced yard)?

PART III - PHYSICAL ENVIRONMENT
 (1) TYPE OF HOME:*

 (2) CONDITION OF THE HOME* (please summarize in text box below)
  • Does it look as though a basset would be welcome there?
  • Does it seem as if the applicant might be obsessively neat or contrary-wise someone who is dangerously sloppy?
  • If the applicants seem to be neatniks, how do they feel about slobbering, shedding, furniture-hogging hounds?
  • From your observation, does it appear that the applicants can afford to adopt a dog? 

 (3) FENCED YARD (if applicable, please summarize in text box below)
  • How high is the fence?
  • What type of fence is it?
  • Is it in good repair? Does it appear to be secure?
  • Type of gate and latch - is it easy to escape?
  • Do they have a dog door?

 (4) OUTDOOR KENNEL AREA OR RUN (if applicable, please summarize in text box below)
  • Is there adequate shade?
  • Is there adequate shelter?
  • How many hours per day will the dog be in the kennel run?
  • Is the floor concrete or grass, and how often will it be cleaned?
 
PART IV - OTHER ANIMALS (if applicable, please summarize in text box below)
 (1) If there are other animals in the home, what are they (dogs, cats, birds, reptiles, rabbits, etc.)? Please comment (as appropriate) on their apparent condition and happiness as you observed them (i.e., are they clean, groomed, nails at an appropriate length, etc.).
 (2) How do the applicants appear to interact with these pets?
 (3) If there are other animals listed as living in the home on the application, but which are not visible - were you able to meet them?
 (4) Does the number of animals that are actually in the home match up with what was put on the application?
 (5) If there are dogs in an outside kennel, are they listed on the application?
 
PART V - ADOPTER PREFERENCES* (please summarize in text box below)
 (1) What among these are the most important characteristics that their new basset should have:
  • Completely and reliably housetrained
  • Gets along well with children
  • Plays well with other dogs
  • Doesn't bother or chase cats
  • Is not a barker
  • Is not shy
  • Is able to stay alone most of the day
  • Looks like a "classic" basset
 (2) Would the applicants consider a:
  • Basset mix
  • Dog with health issues (if so, what?)
  • Dog with behavioral issues (if so, what?)
  • Senior dog (if so, what age?)
 
PART VI - WRAP UP
 (1) In your opinion, what are the applicants' strongest and weakest qualifications to adopt from BROOD? Please include both favorable impressions and anything that may have set off a "warning bell."*

 (2) In your opinion, would you consider the applicants to be:*
  • Highly qualified
  • Qualified but with some reservations (note the reservations below)
  • Not recommended to be adopters (state specific reasons below)

(3) Finally, please be sure to do the following before you leave the house visit:

Your Name:* 
Your Phone:* 
Your Email:* 

 

Please click on the SUBMIT button to send this information to BROOD