Foster Assessment

Please answer all the questions.  Where a response is not applicable please enter “none”.

Your Name

Telephone numbers

Your Email

Dogs Name

Dogs date of birth or age

Gender
 Male, neutered Male, unneutered Male, don't know Female, neutered Female, unneutered Female, don't know

If an unneutered bitch please give the date of her last season, if known

Coat Colour

Dew claws
 Are off Are on

Is the dog house trained/clean in the house?
 Always Night only Day only Mostly Sometimes Never

Does the dog have any health problems of which you are aware? If so please detail

Does the dog have any behavioural problems of which you are aware? If so please detail*

I have walked the dog on a lead and he/she
 Walked quietly to heel Walked slightly ahead Pulled ahead Walked slightly behind Only walked with me reluctantly Seemed unused to walking on a lead I have not walked the dog on a lead

I have tested the dogs reaction to children under 5 and in my opinion he/she
 Seems used to small children and is probably childsafe Seems used to small children but may not be childsafe Seems unused to small children but is probably childsafe Seems unused to small children and may be not childsafe Does not seem small child safe at this time Not tested

I have tested the dogs reaction to children aged 5-12 and in my opinion he/she
 Seems used to older children and is probably childsafe Seems used to older children but may not be childsafe Seems unused to older childer but is probably childsafe Seems unused to older children and may not be childsafe Is not older child safe at this time Not tested

I have tested the dogs reaction to other dogs in the home and in my opinion he/she
 Is entirely accepting of other dogs and playful Is entirely accepting of other dogs but not playful Is cautiously accepting of other dogs Is withdrawn in the company of other dogs Is not accepting of other dogs Not tested

I have tested the dogs reaction to other dogs when on lead and in my opinion he/she
 Is entirely accepting of other dogs Is cautiously accepting of other dogs Barks when approached but settles on meeting Barks when approached and does not settle on meeting Is not accepting of other dogs at this time Not tested

I have tested the dogs reaction to cats and in my opinion he/she
 Is catsafe Is not catsafe at this time Not tested

I have tested the dogs reaction to farm livestock and in my opinion he/she
 Is safe with livestock Is not safe with livestock Not tested

I have crated the dog and he/she
 Settled well Settled reluctantly Settled eventually Did not settle Became very distressed/could not be crated I have not crated

In your opinion what is the maximum time period left home alone with which the dog will cope ?
 Will not cope at all Short periods of less than an hour only Short periods of less than an hour only if he/she has another dog for company 1-3 hours 1-3 hours if he/she has another dog for company 3-5 hours 3-5 hours if he/she has another dog for company Dont know

What has the dog been fed whilst in your care? Please detail.

Please add any other information here that you think may be relevant

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