Minnesota Basset Rescue Foster Home Application
We are excited that you are thinking about fostering one of our lovable hounds!
Minnesota Basset Rescue's Foster Home Conditions
Please be aware that:
1. Reference checks are done on all foster home families.
2. We require the pets of foster families to be current for rabies, distemper, and annual heartworm test and preventative.
I understand that MNBR will contact the vet(s) I list below to verify whether my current or former dogs and/or cats meet MNBR’s vaccination requirements listed above to be approved for fostering (Please only check applicable boxes) *
Required
APPLICANT INFORMATION
Name *
Your answer
Email Address *
Valid email required
Your answer
Address *
Your answer
City, State, Zip Code *
Your answer
Phone Number *
Your answer
Cell Phone Number *
Your answer
Household Information
Do you own or rent?
I live in a:
If you rent, will your landlord give you written permission to have a dog?
Landlord's Name:
Your answer
Landlord's Phone Number
Your answer
Number of Adults (over 18)
Your answer
Number of Children and Ages
Your answer
Is anyone in the family allergic to dogs?
Is someone home during the day?
If so, who?
Your answer
Is someone home at night?
If so, who?
Your answer
How many hours will the dog be home alone?
Your answer
Where will the basset be kept during the day?
Your answer
Where will the basset be kept during at night?
Your answer
Where will the basset be kept when no one is home?
Your answer
YARD
Do you have a fenced in yard?
If yes, what type (wood, chain link, etc.)
Your answer
If my yard is not fenced in, I will keep the dog on leash at all times when outside
If yard is not fenced, what arrangements have you made for exercise and toilet duties?
Your answer
If you have steps leading into your home, how many do you have?
Your answer
If you have steps inside your home, how many do you have?
Your answer
Which family member will be the basset's primary caretaker?
Your answer
DOGS AND YOU
Have you ever fostered a dog before?
Type of dog:
Your answer
How long ago:
Your answer
Have you fostered or owned a basset before:
Have you ever fostered or owned a rescue dog:
If you have fostered previously, please list the name of the shelter or rescue:
Your answer
Are you willing to foster more than one dog at a time?
If yes, what is your limit?
Your answer
Are you willing to foster a basset hound that is recovering from surgery or needs medication?
Are you willing to foster a 'special needs' basset (i.e. blind, disabled or paralyzed)?
Are you willing to foster a senior basset (8+ years of age)?
Are you willing to housetrain, if necessary?
Are you willing to work with a Minnesota Basset Rescue trainer if problems occur?
Will you take the basset to obedience classes if needed?
Are you willing to use a crate to confine your dog when no one is home to supervise?
Have you ever crate trained a dog?
Do you have a crate available?
Comments
Your answer
Have you ever given up a pet?
If yes, what type and why:
Your answer
If you have had or presently have other pets in your family, please complete the following questions:
1. Pet's Name, Type/Breed, & Length of Ownership:
Your answer
Do you still own this pet?
Age
Your answer
Spayed/neutered
Temperament
Behavior with other dogs
Your answer
2. Pet's Name, Type/Breed, & Length of Ownership:
Your answer
Do you still own this pet?
Age
Your answer
Spayed/Neutered
Temperament
Behavior with other dogs?
Your answer
3. Pet's Name, Type/Breed, & Length of Ownership:
Your answer
Do you still own this pet?
Your answer
Age
Your answer
Spayed/neutered
Temperament
Behavior with other dogs
Your answer
4. Pet's Name, Type/Breed, & Length of Ownership:
Your answer
Do you still own this pet?
Age
Your answer
Spayed/neutered
Temperament
Behavior with other dogs?
Your answer
BASSET HOUND CARE AND TRAINING
MNBR vaccine requirements: Rabies and distemper, annual heartworm test and preventive.
Please contact your veterinarian's office to let them know we will be calling
VETERINARIAN CARE
Do you have a regular vet?
* Please note: your vet WILL be contacted to verify the vaccination status of all family pets.
Vet's Name/Clinic Name
Your answer
Phone Number
Your answer
Address
Your answer
City, State, Zip Code
Your answer
Pet(s) Names on Vet records:
Your answer
Family Name on Vet Records:
Your answer
* Please note: your vet WILL be contacted to verify the vaccination status of all applicable family pets.
References
If you do not have a current or regular vet, please submit the names of two references (excluding family members).
Reference 1
Name & Phone #
Your answer
Reference 2
Name & Phone #
Your answer
ALL OF THE ABOVE AREAS MUST BE COMPLETED IN FULL
PLEASE READ ALL THE FOLLOWING CAREFULLY AND CHECK IF YOU UNDERSTAND & AGREE.
I UNDERSTAND I AM RESPONSIBLE FOR AND AGREE TO THE FOLLOWING.
My basset will need an annual heartworm test and preventative medication *
My basset will need an annual check-up and vaccinations. *
My basset will need periodic grooming, nail trims, and ear cleaning *
My basset will need of exercise. *
My hound is a scent hound and must NEVER be left off leash in an unsecured area. *
My basset will not be allowed on a boat or near an unfenced pool without supervision (Most bassets cannot swim due to their body configuration and could easily drown.) *
I understand and agree that Minnesota Basset Rescue will be responsible for medical care, routine or otherwise, while the dog is in foster care if the following provisions are met: 1. The foster dog is under the care of a vet that has been approved by MNBR. 2. The medical care has been discussed with appropriate foster home coordinator prior to treatment being given (emergency care excepted). 3. The MNBR foster home coordinator has the final authority to authorize, determine and approve the necessary and appropriate treatment after discussion with the vet and foster home. *
I understand that my basset hound is a house dog and is not to live, be kenneled or chained, outside for an extended period of time. *
I have read, understood and agree to comply with all of the requirements of the Minnesota Basset Rescue Foster home stipulations and policy as listed here as well as in the foster home policy statement on this site. *
Furthermore, I understand that MNBR has little or no prior knowledge of a foster dog’s temperament, and I therefore will take all due care to protect myself and others who may come in contact with the dog. I further agree to not hold Minnesota Basset Rescue responsible for property damage, bodily injury or harm to any persons caused by this dog while it is in my care and custody *
I authorize the verification of any and all information as provided on this form as it is, to the best of my knowledge, true and complete. I further understand that falsifying answers on this application or at any other time to a MNBR representative disqualifies me from fostering or otherwise participating as a volunteer for Minnesota Basset Rescue, (MNBR). I am aware that submission of this application does not guarantee that I will be approved as a MNBR foster home. *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service