BROOD Foster Families, please complete this form within two weeks of getting the dog, and once a month thereafter.

Dog Name *

Dog Approximate Weight (pounds)

Foster Parents Name *

E-mail Address: *

Foster Home Phone *

Foster Cell Phone

Date of Last Heartworm Treatment *

Brand of Heartworm Treatment HeartgardInterceptorProheartRevolutionSentinelTri-Heart

Other Heartworm (please specify)

Date of Last Flea Medication *

Brand of Flea Medication AdvantixBravectoFrontlineHartzNextgardRevolutionSimparicaOther (please specify)

Other Flea Medication (please specify)

Is your foster dog on any other medications? *

Yes
No

If yes, explain in detail

Is your foster dog housetrained? *

Yes
No
Partially
Unknown

Is your foster dog crate trained? *

Yes
No

If your foster dog is crated, how many hours a day and days a week?

Is your foster dog door trained? *

Yes
No

How does your foster dog walk on a leash? *

Correctly
Pulls
Hangs behind

Does your foster dog ride well in the car? *

Yes
No

Would you describe your foster dog as *

Quiet
Vocal

When is your foster dog most likely to bark? *

What is your foster dog’s attitude toward people? (check all that apply) *

Friendly
Pushy
Laid back
Shy
Energetic
Aloof

Is your foster dog allowed on the furniture? *

Yes
No

Is your foster dog allowed on the bed? *

Yes
No

Does your foster dog have any physical limitations regarding stairs? *

Yes
No

If yes, please explain

What are your foster dog’s exercise needs? *

High
Average
Low

How much and what type of exercise does your foster dog receive daily/weekly? *

How long is your foster dog alone every day? *

Does your foster dog suffer separation anxiety? *

Yes
No

If yes, please explain

Does your foster dog suffer thunder phobia? *

Yes
No

Does your foster dog have any issues with grooming (nails clipping, ear cleaning, etc.)? *

Yes
No

If YES, please explain.

Does your foster dog live with children? *

Yes
No

My foster dog would do best in a home *

With children
Without children
Either

If your foster dog would do well in a home with children, is there any limitation on the ages of the children? Explain

Does your foster dog live with other dogs? *

Yes
No

What is your foster dog’s attitude toward other dogs? *

Friendly/Playful
Friendly/Laid Back
Timid/Shy/Fearful
Withdrawn/Depressed
Aloof
Pushy/Dominant
Submissive

Would your foster dog be okay as an only dog? *

Yes
No

If NO, please explain

Does your foster dog require a home without other dogs? *

If yes, please explain

Does your foster dog live with cats? *

Yes
No

What is your foster dog’s attitude toward cats?

Playful
Friendly but quiet
Ignores them
Aggressive
Fearful

Does your foster dog chase small animals such as squirrels, rabbits, etc.? *

Yes
No

Has your foster dog EVER shown any form of aggression (snarling, snapping or biting)? *

Yes
No

If YES, please describe the circumstances

Would your foster dog be okay living in an apartment in a city and going on walks with city noise? *

Yes
No

If no, please explain.

Would your foster dog be okay living in a home with no fenced yard? *

Yes
No

If no, please explain.

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, please give details

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

Yes
No

If YES, describe improvements

Has your foster dog has any setbacks in the past month? *

Yes
No

If yes, please explain

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

Does your foster dog have any unique behaviors, characteristics of talents that would appeal to an adopter? *

Yes
No

If yes, please explain

Does your foster dog have a favorite treat, snack, toy, blanket, game, etc.? *

Yes
No

If yes, please explain

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

Yes
No

If not ready for adoption, please explain why.

In a couple of sentences, describe the dog’s personality and best characteristics for use in its online biography. (Please be as detailed as possible to help us write the biography.) *

Do you have a new photo to submit? (Email additional photos to fosterdogphotos@brood-va.org) *

Yes
No

If yes, attach photo

Do you have a new video to submit? (Email to fosterdogvideos@brood-va.org) *

Yes
No

Is your foster dog afraid of anything? (Examples: children, loud noises, men, women, uniforms, riding in cars, water, etc.)

Yes
No

If yes, please explain.

People describe my foster dog as: (check all that apply)

Lap loving
Social butterfly
Mellow
Curious
Active
Playful
Loner

Has your foster dog received any training since being placed with you?

Yes
No

If yes, please explain.

Does your foster dog know any commands?

Yes
No

If yes, please explain.

Overall what is your foster dog’s activity?

Low
Moderate
High

Verification Code:

Enter Verification Code: *

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