Foster Survey for HEART
Thank you for your interest in fostering a dog for HEART! You must be at least 21 years old to complete this survey. Our pets are vetted and provided care in the Raleigh/Cary area and our events are in the Raleigh/Cary area. Foster families need to live close enough to bring the pet for vet care and events in the Raleigh/Cary area. All questions that pertain to you require an answer, with or without an *. Failure to answer will delay processing of your application. There is additional space at the end of the survey if you need more room to answer questions.
Sign in to Google to save your progress. Learn more
1. Your name: *
2. Your complete address (including street, city, state, zip code): *
3. Phone Number 1: *
4. Phone Number 2:
5. Email: *
6. I am currently employed *
7. Age: *
8. I have lived at this address for *
9. If less than 2 years, what was your previous address and how long did you live there?
10. If you are planning to move in the next year, when do you plan to move and where? *
11. Tell us about where you live *
If you rent, rent-to-own, or live in a family owned home (YOUR name is not on the deed), please include name and contact information for the property owner (we will not process your application without this information):
12. List the phone number and name of the vet hospital you use/used: *
13. Provide the name and phone number of two references NOT related to you, NOT living in your home, and NOT your vet: *
14. Please check if you are: *
Required
15. List the members of your household and their relationship *
16. List the ages of children who live in or visit your home regularly. If no children, say "none". *
17. The person who most wants to foster a dog is *
Required
18. Who will be the primary caretaker? *
19. Please describe your home activity level *
Required
20. On the average work day, how many hours would the dog be left alone? *
21. Is there a completely fenced yard? *
22. What type of fence do you have?
23. What is the approximate size of the fenced area?
24. How tall is the fence:
25. If there is no fence, how do you keep (or plan to keep) dogs safe and in compliance with confinement laws?
26. List ALL pets currently living in your home. Give name, breed, age, gender, and how long they've lived there. Number each pet (if no pets, say "none"). This includes dogs living at your home not owned by you: *
If any pets are not spayed/neutered, please explain:
27. List all pets you have had in the last 10 years not currently living in your home and what happened to them (number each pet):
28. What form of heartworm prevention do/did you use? *
Where do/did you purchase heartworm preventatives? *
29. May we contact your vet as a reference? *
30. Are the records in your name? *
If records are not in your name, please provide name on records:
31. What food do/did you feed your dog? How did you decide what to feed your dog? *
32. When interacting with other dogs, current/previous dog #1 reacts by:
33. When interacting with other dogs, current/previous dog #2 reacts by:
34. I would like to foster: *
Required
35. I would describe my current/previous dog(s) as *
Required
36. To help with training the foster dog, I plan to: *
Required
37. I am expecting the dog's obedience/behavior training to take *
Required
38. When I think about giving a dog a verbal reprimand (e.g., no, off, leave it), I feel *
Required
39. When it comes to crate training, I am *
40. I usually have my dog off leash when:
 *
41. I plan to share the following parts of my home with the dog *
Required
42. The dog is chewing my favorite shoe. I'm likely to *
43. I go to bed and find the dog already lying in my spot. I'm likely to *
44. If while out for a walk, the dog sees another dog and pulls me toward it, I am likely to *
45. If I tell the dog to "sit" and he stares blankly back at me. I am likely to *
46. If the dog chases a child around the house, I'm likely to *
47. If the dog jumps up on a visitor, I'm likely to *
48. If I reach for the dog and it runs away or under furniture, I'm likely to *
49. If I ask the dog to do something and the dog growls, barks, and/or snaps at me, I'm likely to *
50. If the dog bites me (may or may not draw blood), I'm likely to *
51. I am willing to foster a dog with health issues:
52. List any reasons you would return a foster *
53. Does anyone in your home have allergies to dogs? *
54. IF you would be interested in training a dog for service, therapy, or Emotional Support Animal, please describe your interests/experience below: *
55. HEART will need to call, email, or text you from time to time. Will this be a problem for you? *
If you needed more space for responses above, use this area to elaborate. Include the number of the question you are answering. Also use this space for any additional comments or concerns you may have.
How did you hear about HEART? *
By typing your name and the date below, you are agreeing that you have answered the above information honestly and to the following:  You give HEART permission to fully investigate the information provided as well as contact veterinarians and others for records. If any information on this application is found to be false, even after approval, you will forfeit all rights to foster the pet. You understand that the final decision to send a dog out to a foster home rests solely with HEART and is based on many factors, including the compatibility of the family and home to the individual pet. *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms