VBTR House Check

Thank you for doing a house check for a potential foster/adopter/volunteer of Victorian Bull Terrier Rescue Inc. NOTE: Fields with a * are mandatory and should be completed for the form to submit correctly. Please provide as much detail as possible when completing the form and ensure plenty of photos are taken (these should be uploaded in the fields provided at the end of this form, prior to clicking Submit).

When arriving at the house check – introduce yourself and advise that you are here on behalf of Victorian Bull Terrier Rescue.
Applicant 1 - First Name *
Surname *
Applicant 2 - First Name 2
Surname 2
Address *
Town/Suburb *
State *	Victoria ACT New South Wales Northern Territory Queensland South Australia Tasmania Western Australia
Postcode *
Email address * Please ask the applicant to supply the email address provided in their initial application.
Confirm email
Attendees * Are all house occupants there on the inspection?	Yes No
Contact Number * Please supply at least one applicants preferred contact number
Household Members Please detail all household members here
Who is in attendance? If all applicants are not present for the inspection, please outline who is present and who is absent.
PhotoID * Ask to see photo ID. Only select "yes" if it confirms their name/s and the address of the house check. Please include a photo of the ID at the bottom of this form.	Yes, the names and address match the housecheck location No, the details do not match
Fencing * Are the fences secure? ie no holes, missing palings, are palings rotted, attached firmly.	yes no
Fencing - details Please provide details
Neighbouring dogs * Are there any dogs along the fence lines?	yes no
Neighbouring Dogs - details Please provide details
Fence Height * Type and approx. height of fence? ie timber paling, 6ft high.
Gaps in Fencing * Any gaps underneath fence where dog can get out?	yes no
Gaps in Fencing - details
Digging * Soil, is it soft where dogs could dig out?	yes no
Digging - details Soil, is it soft where dogs could dig out?
Gate type Gates: type and closing mechanism. ie height, loose or secure, padlocks, are the gates see through?
Climbing * Furniture ie pots, BBQs, garbage bins, or other things which a dog could hop onto then climb over the fence.	yes no
Climbing - details Please provide details
Maintenance * Is the yard clean and tidy? Are buildings well maintained? I.e rubbish, is the lawns mowed, clean of food scraps, faeces etc? Please select "no" If there is anything you are concerned a dog can hurt themselves on.	yes no
Maintenance- details
Shade/Shelter * Is there shade/shelter in the yard from the elements ie rain and sun?	yes no
Shade/Shelter - details Please describe in detail
Plants etc * Is there any poisonous plants or plants that could cause allergies?	yes no
Plants etc - details
Inside * Is the dog is going to be allowed inside?	yes no
Inside - details View the areas the dog will be allowed to be in, and where the dog will sleep. Describe in detail
Where will the dog sleep? * Please select all that apply	Inside - crate Inside - dog bed Inside - no dedicated sleeping space Outside - crate Outside - kennel Outside - dog bed Outside - verandah
Sleeping Arrangements - details Please describe in detail
Clean/Tidy * Is the house clean and tidy and free from any hazards?	yes no
Clean/Tidy - details Please describe in detail
Time allowed inside Try to get some idea of how often the dog will be allowed inside.
Are there any other pets? Tick all that apply.	N/A Dog/s Cat/s Birds Poultry Livestock Small Pets (rabbits, guinea pigs, reptiles etc)
Pet/s details Ask to see them. Note down type, sex and age and desex status for any dogs.
Pets Condition Are the pets in good condition and does the owner seem to have effective control over their behaviour?	yes no
Pet/s Condition - details Please describe in detail
Pet/s Behaviour If dog or cat are they friendly towards you or are timid/frightened of you?
Pet/s Behaviour - details Please describe in detail
Primary Carer Who is going to primarily care for the dog ie adult, children?
Purchases Have they purchased anything for the dog yet, such as kennel, food or bed?
Children If there are children, are the children clean and tidy and well behaved?
Attitude/s Impression of the people, attitude and are they all keen to get a dog
Recommendation * Would you feel happy for a Victorian Bull Terrier rescue Inc. dog to reside within this property?	yes no
Recommendation - details Please describe in detail
Photo ID Image Please attach images of fences/gates
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Do you need to load more images?	Yes No
VBTR house check rep name * House check completed by
VBTR house check rep email * Email for any further questions we may have for you:
Date of house check *
Digital Signature * VBTR House Check Representative	Clear

When leaving, advise that you will be reporting back to Victorian Bull Terrier Rescue and a representative will be in contact with them with feedback. Thankyou again for supporting VBTR!