Homeward Bound Golden Retriever Rescue Adoption Evaluation



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Homeward Bound Golden Retriever Rescue

Adoption Evaluation


Dog Name: Dog Number: 2015 – Date:


Age: 6 years  Male  Female Purebred  Mix   O/S  Shelter Level  1 2  3
SUMMARY

 Kids, cats and dogs okay


Kids  Yes  Kids only over:  No Kids  Unknown

Cats  Yes  No N  Tested yes, but may chase  Unknown L

Dogs Yes  No K  Unknown  Reactive Small dogs  Yes or  No K X Unknown
Training needs Yes  No Comments: ______________________________________________________
Type of Home Recommended:

 Good with kids, cats and dogs

 Must be only dog in home  Must be only animal in home (prey drive)
Active family with kids; kid’s age: 15 years +  Needs more activity than daily walking

 Active Adults, no kids  Needs aerobic exercise a.m. and p.m.

 Semi-active family or individual  Daily walks
 Medical needs  Must take medication  Special Needs
Describe: None
 No stairs - Limited mobility  Needs someone home 24/7 due to behavior or medical issue

 Needs to live with another dog  Dog must be inside home 24/7




Other Behaviors Observed/Stated by Owner Surrender

Level 1

Level 2

Level 3

  • Fine, no problems noted

  • Friendly and calm

  • House trained

  • Good house manners

  • Hyper, very active

  • Jumping on/mounting people

  • Climbing fences/ escaping

  • Some house training




  • Mouthing hands, arms, or clothes

  • Separation anxiety

  • Other anxious behavior

  • No house training




Other, please describe: _____________________________________________________________________

Body examination:

X Level 1

Level 2

Level 3

  • Teeth: turns head/body away, but will allow

  • Belly: dog will allow touching from underneath

  • Ears: turns head/body away, but will allow or has medical issue (note above)

  • Teeth: turns away then growls, lip curl, will not tolerate

  • Belly: dog will not roll over or tolerate touching from underneath

  • Ears: dog turns head/body away and won’t allow, growl or lip curl

Other, please describe:


GENERAL BEHAVIOR

Meeting People:

Level 1

Level 2

Level 3

  • Friendly and eager to meet people

  • Happy tail wag

  • Fearful and backs away

  • Barks at people

  • Growls or shows teeth




Other, please describe:

Approach to Touch/Petting:

Level 1

Level 2

Level 3

  • Happy and affectionate

  • Offers belly/submissive

  • Eye contact

  • Places paw on person

  • Leans into person (Velcro)

  • Pulls away/walks away-no interest at first

  • Timid/shy, but will allow

  • Head shy

  • Some eye contact

  • May not like to be touched in specific area of body (please note below)

  • Fearful/shaking/drooling/belly crawl/stays low to ground

  • Eyes are wide and showing whites (whale eye)

  • Body stiff and freezes (fear)

---------------------------------------

  • Body stiff, tense, leaning forward (aggressive)

  • Whips head around with stare

  • Growls, barks, lip curls, snarls, or snaps (please note if fear or aggressive below)

Other, please describe: ____________________________________________________________________________


Body Examination Specific Sensitivity Issues/Dislikes:

 Grabbing collar  Touching paws/pads Touching tail Touching back/rear end  Touching under body

 Other, please describe: __________________________________________________________________________
SOCIAL SKILLS

Reaction to dogs while on leash:

Level 1

Level 2

Level 3

  • Fine, no problems noted

  • Friendly, wants to play

  • Uncomfortable, fearful, pulls to get away

  • Lunges/growls/barks (note distance)

Other, please describe: ___________________________________________________________________


  • Dog tested for reactivity:  Yes or  No Date: May-June, 2015 Reactive?  Yes or  No

  • If yes, enrolled in Reactive Class? Yes or  No Date:____________


Reaction to dogs at fence:

Level 1

Level 2

Level 3

  • No reaction

  • Looks but ignores

  • Only reacts to the other dog barking/lunging

Other, please describe:

Reaction to cats:

Level 1

Level 2

Level 3

  • Indifferent/ignores

  • Fearful of cat

  • Likes cat, wants to play

  • Interested, could chase

  • Chases to play, could harm?

  • Overly interested

  • Chases with intent to harm (prey drive)

Other, please describe: He has been around the office cats several times and paid them no mind. However, I would be surprised if he did chase then if they ran.
Reaction to other animals/prey drive:

 Rabbits  Squirrels  Birds  Small Dogs  Other: __________________________




Level 1

Level 2

Level 3

  • No reaction-indifferent

  • Fixated or obsessed – chases with intent to harm

Other, please describe:

TOY BEHAVIOR

Relinquish toys/bones/soft toys

Level 1

Level 2

Level 3

  • Releases easily, knows “drop”

  • Will trade easily for another toy/treat

  • Turns head/body or walks away and will not release

  • Wants to play “chase me”

Comments: _________________________________________________________________________________________OD



FOOD BEHAVIOR

Assess hand reaction with food in bowl

Level 1

Level 2

Level 3

  • No reaction

  • Eats extremely fast

  • Protects bowl (no growl)

Comments: ______________________________________________________________________________________

________________________________________________________________________________________________

ENVIRONMENTAL

Ability to use steps

 Fine, no issues  Slowly, may need assistance and/or encouragement



  • Fearful, will not attempt  Unable, mobility limitations

  • Other:________________________________

Swims?  Yes  No  Unknown Needs a Pool? Yes  No  Needs to live inside home 24/7

 Needs large area to run Other: ____________________________________________________________



OBEDIENCE SKILLS

Leash Skills:

Level 1

Level 2

Level 3

  • Walks well on leash

  • Lags behind, needs encouragement (fearful or training issue)

  • Moderate puller on leash

  • Pulls toward people or other dogs, but can be trained






  • Pulls hard on leash, difficult to manage

  • Lunges at other dogs/people in passing


Knows Obedience Cues:

X Sit X Down ☒ Stay X Come ☒ Give Paw/Shake ☒ Drops toys on cue X Leave it ☒ Fetch

☒ Other: Could use some more obedience training


Manners When Taking Treats:

Level 1

Level 2

Level 3

  • Soft mouth

  • Over excited – some teeth

  • Can be trained




  • Hard mouth, grabby, bites

Bathing/Brushing:

Level 1

Level 2

Level 3

  • Enjoys it

  • Easy to brush

I


  • Tolerates to a point

  • Moves away when has had enough

  • Shows some fear

  • Does not tolerate and Moves away

  • Growls

  • Fearful

(please note if fear or aggression)





Evaluated by: Rob Kessel


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