Wellness Home Visit Checklist

Wellness Home Check Instructions

To ensure that our foster dogs are receiving the best possible care, periodically wellness home visits will be scheduled between the foster home and another Speaking of Dogs Rescue (SODR) volunteer. If you have been asked to do a wellness home visit, the foster coordinator will provide you with the pertinent information regarding the dog and its specific needs (i.e. medication, grooming, etc.) so that you can provide a thorough report on the dog and its environment. You will also be provided with the contact information of the foster home so that you can arrange a mutually agreeable time for the home visit. Prior to your visit, you are encouraged to review the dog’s write-up on our web site. Once you’ve completed the form, please email it back to your foster coordinator. Please remember to be courteous. Our foster homes are our most treasured asset. They deserve our respect and graciousness. If you find there are any concerns, please do not confront the foster parent. Note the concern(s) on the form. If urgent, you may want to call the foster coordinator.

General Information

Date *

Name of Evaluator *

Evaluator's Email *

Name(s) of foster parent(s) *

Name of Dog(s) being fostered *

Foster Parent's Phone *

Foster Parent's Email *

Foster Parent(s) Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Wellness Checklist/Observation Form

Foster Dog's Name: *

1. Does the dog look well groomed? *

Comments on grooming

2. Does the dog have any physical signs of distress or decline (e.g. limping, shaking head, signs of compulsive licking, mobility, or vision issues). *

Comments on physical appearance

3. Does the dog show any emotional signs of distress that is not already known to the rescue (e.g. fearful, showing calming signals, etc.) Calming signals include lip-licking, yawning, looking away, freezing. *

Comments on signs of distress

4. Check on meds and ask the foster parents to show you any medications or supplements the dog is taking. Have all medications/supplements been cleared by our veterinarian and/or Foster Coordinator? Are they giving them to the dog as prescribed? *

5. Ask them about their last vet visit and ask about any recent concerns. Has Cheryl been notified? *

6. Describe the home's interior – clean, tidy, safe, cluttered, etc.? Note any potential problems (e.g. loose wires, uneven/loose floor surfaces, steep unprotected drops, toxic plants, accessible garbage, small choke-able toys lying around). *

7. What areas of the home does the dog have access to? *

8. Does the dog have access to water? *

9. Where does the dog sleep? *

Describe the home's exterior. If there is a yard, is it fully fenced? Are there any gaps or places the dog coud escape (between fences or bottom of fence)? Does the gate latch properly? Is the yard free of debris and feces? *

Describe any balconies/decks the dog will have access to (height, gaps between the floor and the bottom of the balcony/deck, side gaps). *

10. If there are other pets in the home, describe the interaction of them with the foster dog. Are their own pets well groomed and appear happy? *

11. Ask the foster parent(s) if there have there been any change of circumstances where they may need any additional support from Speaking of Dogs. *

12. Observations and comments from evaluator: *