Foster Intake Form This form is only for our foster parents to submit so we have information to communicate to the handlers Step 1 of 2 50% Foster Parent (First Name Only)* First Name only in this field. The PDF can not be edited after submission. If you include your last name you will have to resubmit. Foster Dogs Name* Male or Female*MaleFemaleFoster Dog's Age*Only enter numbers if under a year old please type 06, 04 over 1 would be 1, 2,3,4Foster Dog's Breed (best guess)* Best Guess on dogs breed is completely acceptable on this form. Dogs weight, (Estimate is fine if you don't know)*Only enter numbers no # signType of rescue* Shelter Transfer Owner Surrender Stray Known Health Issues/Additional Background InformationIf your dog has had intestinal issues, Has a limp or any medical treatments its best to list them here. Date that Heart worm, Flea and Tic medicine is due.* MM slash DD slash YYYY If flea medicine was given on a different date than the Heart worm medicine that is OK. We do not Administer flea med's in the prison program. Temperament with Dogs, Cats, KidsWas Dog Fully Temp tested* Yes No Issues, (If you click this box another box will open so you can explain) Please Explain any issues with temp testWas Dog Tested with Children* Yes No Issues Explain any issues with ChildrenWas Dog tested with other dogs* Yes No Issues Dog to Dog Test Please explain if there could be any issues.Does Dog have any fears? If yes please explain.*Afraid of the vacuum, walking out a doorway, fearful of people Etc.Was Dog Tested with Cats? Please explain the outcome.* Fence Requirements, Riding in carsFence Required?* Standard Only 6 foot Privacy Fence Wire less fence No fence requirement Issues Please check the type of fence your foster requires. If you click issues it will open up a box to explain why the dog needs what it needs. Additional Information about the fence requirementList here if there are any issues the handlers or the rest of the group should be aware of. Does Dog travel well in the car* Yes No Issues Please explain any issues with Riding in a vehicleDietary Needs, Amount of food the dog is needing, any supplements required.Current Dog Food your Foster is Eating* Brand and Flavor if you still have the bag.How many times a day is the Dog eating? How much per feeding?* example 1 cup 2xs a dayAny Special Dietary NeedsPlease fill this in if you foster needs a special food, fish oil pills, hip/joint chewsKnown Commands and Additional Information RequiredList Known Commands HereIf your dog knows sit, wait, etc. Additional Information*List everything you know about your Foster dog here. This part of the form is very important to the handlers, the more info you share the more they can prepare for the dog ahead of time. Photo of your Foster Dog* Photo of your Foster Dog
