RESCUE DOG VILLAGE
Vet Check Form
GUIDELINES
You are a representative of Rescue Dog Village,
The following suggested statements will help you break the ice:
- I am a Volunteer for Rescue Dog Village, could you please take a moment to tell us about our applicant;
- Or rescue dogs are very important to us and we want to make sure that the people who we trust them with are responsible owners;
- Your opinion and information is very valuable to us;
- Thank you so much for assisting us with our efforts.
APPLICANT NAME:
RESCUE DOG NAME(S)
Vet's Name:
Vet's Phone Number:
Vet's Street Address:
Vet's City:
Vet's State:
Vet's Zip:
8. Are you currently seeing any of the applicant's pet(s)?
Select
Yes
No
If no, did you provide vet care previously?
Select
Yes
No
..........If yes, which pet(s)are you seeing?
9. Were are all pet(s) kept up to date on their vaccinations?
Select
Yes
No
a. If not, which ones were are overdue?
b. Were are there medical reasons for them not having been vaccinated?
10. Were are all pet(s) kept up to date on heartworm preventatives?
Select
Yes
No
a. If not, were are there medical reasons?
Select
Yes
No
b. Please explain:
11. Were are all pet(s) neutered/ spayed?
Select
Yes
No
12. Is the applicant in good standing?
Yes
No
Refused to answer
13. Vet's Recommendation:
Highly Recommend
Recommend
Does Not Recommend
Does Not Know Applicant
14. Person you spoke with at the vets office:
15. Comments:
Date Vet Check Done:
Date Vet Check Submitted:
Volunteer's Name:
Volunteers Email Address:
After you have entered all the informaiton, please click the submit button: