Case Officer Report

Subject: *

Case officers name

E-mail Address: *

Dogs name *

Dogs date of birth/known age/estimated age *

Coat colour *

Height to shoulder, if known

Weight, if known

Gender/neuter status *

Male, neutered
Male, unneutered
Male, dont know
Female, neutered
Female, unneutered
Female, dont know

Date of prior neuter, if known

If neutered while in foster, date of neuter/contact details of neutering vet/cost of neuter

If unneutered/too young to be neutered, date by which neutering expected?

Vaccination status *

Vaccinated, with card
Vaccinated, without card
Vaccination pending
Not vaccinated
Vaccination status unknown

Date of last vaccination, if known *

If vaccinated while in foster, date of vaccination/contact details of vaccinating vet/cost of vaccination

Current location of vaccination card *

With original owner
With transporter
With fosterer
With adopter
With case officer
With Alison
Unknown/other/no vaccination card

KC name, if known to be registered

KC registration papers available?

Yes
No

Current location of KC registration papers, if applicable *

With original owner
With transporter
With foster carer
With adopter
With case officer
With Alison
Other/unknown

Racing name, if known/applicable

Is dog microchipped

Yes
No
Unknown

If microchipped while in foster, date of microchipping/contact details of microchipping vet/cost of microchipping

Current location of microchip paperwork, if applicable *

With original owner
With transporter
With fosterer
With adopter
With case officer
With Alison
Other/unknown

Picked up from/relinquished by *

Current location of relinquishment form, if applicable *

With transporter
With fosterer
With case officer
With Alison
Other/unknown

Relinquishment donation, if any, amount and date of payment, form of payment, and to whom paid

Date received by Scruples *

If in foster, current fosterers name, address, telephone number/s and email, and date foster placement commenced *

Transported to fosterer/s by, name/s and date/s

On arrival in foster was dogs general condition

Excellent
Acceptable
Poor
A cause for concern

On arrival in foster was dog

Very overweight
Overweight
Normal weight
Under weight
Very underweight

Names and dates re. previous Scruples foster placements, if any

Adoption status *

Currently unavailable for adoption
Available for adoption
Adopted pending homecheck
Adopted

If adopted, home check completed by/date of homecheck

If adopted, adopters name, address, telephone number/s and email, and date of adoption *

Adoption donation, amount and date of payment, form of payment, and to whom paid

Current location of adoption contract, if applicable

With fosterer
With transporter
With adopter
With case officer
With Alison
Other/unknown

Transported to adopter by, name/s and date/s

On adoption was dogs general condition

Excellent
Acceptable
Poor
A cause for concern

On adoption was dog

Very overweight
Overweight
Normal weight
Underweight
Very underweight

Date by which adoption follow up visit due (3 mths from adoption max)

Date adoption follow up visit carried out

At adoption follow up visit was dogs general condition

Excellent
Acceptable
Poor
A cause for concern

At adoption follow up visit was dog

Very overweight
Overweight
Normal weight
Underweight
Very underweight

Please detail any remedial action agreed with adopter after follow up visit

Please detail any other issue raised at follow up visit

Please add any other relevant information here

* Required

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