Monthly/Post Foster Check-in - Colorado Animal Rescue

Date*

Animals Name*

Please describe the incidents*

Please tell us how things are going with your foster dog! We are here to help with whatever you might need.*

In an effort to better advertise your foster dog, please write a paragraph highlighting the dogs personality and things you love about them.*

Please let us know what you need. We will be in contact to set up a time for you to pick the supplies up.*

Excitability

Instructions: Some dogs show little reaction to exciting events, while others become highly excited at the slightest novelty. By selecting a number on the following 5-point scales (0=Calm, 4=Extremely excitable), please indicate your own dog’s recent tendency to become excitable in the following circumstances (please select only one number):

	Calm: little or no special reaction 0	Mild Excitability 1	Moderate excitability 2	Excitable 3	Extremely excitable: Over-reacts, hard to calm down 4
Just before being taken on a walk
Just before being taken on a car trip

Aggression

Instructions: Most dogs display aggressive behavior from time to time – e.g. barking, growling, baring teeth, snapping, etc. By selecting a number on the following 5-point scales (0=No aggression, 4=Serious aggression), please indicate your own dog’s recent tendency to display aggressive behavior in each of the following circumstances (please select only one number):

	No aggression: No visible signs of aggression 0	Mild aggression 1	Moderate aggression: growling/barking–baring teeth 2	Aggressive behavior 3	Serious aggression: Snaps, bites or attempts to bite
When approached directly by an unfamiliar person while being walked/exercised on a leash.
When toys, bones or other objects are taken away by a household member.
When approached directly by a household member while s/he (the dog) is eating.
When mailmen or other delivery workers approach your home
When his/her food is taken away by a household member.
When approached directly by an unfamiliar dog while being walked/exercised on a leash.
When strangers walk past your home when your dog is outside or in the yard.
When barked, growled, or lunged at by another (unfamiliar) dog
When approached while eating by another (familiar) household dog (leave blank if no other dogs).
When approached while playing with/chewing a favorite toy, bone, object, etc., by another (familiar) household dog (leave blank if no other dogs).

Fear and Anxiety

Instructions: Dogs often show signs of anxiety or fear when exposed to particular sounds, objects, persons or situations – e.g. crouching or cringing with tail tucked between the legs; whimpering or whining, freezing, trembling, or attempting to escape or hide. Using the following 5-point scales (0=No fear, 4=Extreme fear), please indicate your own dog’s recent tendency to display fearful behavior in the following circumstances (please select only one number):

	No fear/anxiety: No visible signs of fear 0	Mild Mild fear/anxiety 1	Moderate fear/anxiety 2	Prominent fear/anxiety 3	Extreme Fear: Cowers; retreats or hides, etc 4
When approached directly by an unfamiliar person while away from your home.
In response to sudden or loud noises (e.g. thunder, vacuum cleaner, car backfire, road drills, objects being dropped, etc.).
When an unfamiliar person tries to touch or pet the dog.
In response to strange or unfamiliar objects on or near the sidewalk (e.g. plastic trash bags, leaves, litter, flags flapping, etc.).
When approached directly by an unfamiliar dog.
When approached directly by an unfamiliar dog while being walked/exercised on a leash.
When first exposed to unfamiliar situations (e.g. first car trip, first time in elevator, first visit to veterinarian, etc.)
When barked, growled, or lunged at by an unfamiliar dog.
When having nails clipped by a household member.
When groomed or bathed by a household member.

Separation-related behavior

Instructions: Some dogs show signs of anxiety when left alone, even for short periods of time. Thinking back over the recent past, how often has your dog shown each of the following signs of anxiety when left, or about to be left, on its own (please check only one box per question):

Attachment and Attention-seeking

Instructions: Most dogs are strongly attached to their people, and some demand a great deal of attention and affection from them. Thinking back over the recent past, how often has your dog shown each of the following signs of attachment or attention-seeking (please check only one box per question):

	Never	Seldom	Sometimes	Usually	Always
Tends to follow you (or other members of the household) about the house, from room to room.
Tends to sit close to, or in contact with you (or others) when you are sitting down

Training and obedience

Instructions: Some dogs are more obedient and trainable than others. By checking the appropriate boxes, please indicate how trainable or obedient your dog has been in each of the following situations in the recent past (please check only one box per question):

Miscellaneous problems

Instructions: Dogs display a wide range of miscellaneous behavior problems in addition to those already covered by this questionnaire. Thinking back over the recent past, please indicate how often your dog has shown any of the following behaviors (please check only one box per question):

	Never	Seldom	Sometimes	Usually	Always
Chases or would chase birds, given the chance
Chases or would chase squirrels, rabbits, etc., given the chance
Escapes or would escape from home or yard, given the chance
Chews inappropriate objects
Urinates against objects/ furnishings in your home
Urinates or defecates when left alone in the home
Playful, puppyish, boisterous
Active, energetic, always on the go

Comments

This field is for validation purposes and should be left unchanged.

	Never	Seldom	Sometimes	Usually	Always
Restlessness/agitation/pacing
Barking or whining
Chewing/scratching at doors, floor, windows, curtains, etc.

	Never	Seldom	Sometimes	Usually	Always
Obeys a “sit” command immediately
Obeys a “stay” command immediately
Easily distracted by interesting sights, sounds or smells

Monthly Foster Check-in Form