Pom Haven Rescue

Foster Home Volunteer Form

For the questions below, underline, check, or circle  all answers that apply and/or supply written details if specified.

1. What type of home do you live in?  CONDO    TRAILER      APARTMENT  

SINGLE FAMILY HOME        OTHER (describe):

2. How long have you lived at your present address?

3. Do you  OWN   RENT     your home? 

If you rent, include copy of written permission from landlord to keep dogs.

4. Do you have a fenced yard?    YES    NO

Please describe your fencing. (height/material)

5. Does it completely enclose a yard for a dog?    YES    NO

6. Age and sex of children in household:

7. Are there any other residents in the house?

8. Do you currently have other pets/animal companions?     YES    NO
If yes, list all species, age, and breed.

9.  Are your other pets spayed/neutered?    YES    NO    SOME ARE
If some are not spayed/ neutered, why not?

10. Have you ever had to relinquish a dog?    YES    NO
If yes, list circumstances:

11. Have you owned a Pomeranian/ small breed dog before?    YES    NO

12. Do you agree to contact Pom Haven if you can no longer keep this dog?   

YES    NO

13. What is your age preference?       Why?

14. What sex do you prefer?  male ____ female ____ doesn't matter           

15. I would like to foster a dog that is:   quiet       playful with people    

playful with dogs      moderately active     very active          no preference 

16. It is okay if the dog is:    shy   not good with cats    not good with other dogs  not good with children    not good with men     not good with women  

dependent on people       not housebroken       un-socialized

in need of ongoing medical attention

17. I consider myself an:    experienced    somewhat experienced   

novice dog owner.

18. Where will the dog/puppy be housed during the day when you are home?

19. Where will the dog/puppy stay while you are gone during the day?
 LOOSE INSIDE    CRATE    OTHER (describe)

20. Where will the dog/puppy sleep at night?  LOOSE INDOORS   CRATE   OTHER (describe)

21. How many hours are you away from home each day?

22. Would you be willing to let a representative of Pom Haven visit your home by appointment?   YES    NO

23. Do you smoke? YES   NO

24. How did you hear about Pom Haven volunteer foster program?

Guidelines for Fostering and Agreement

The foster home serves as a safe and comfortable environment for the rescue dog and allows us to get to know something about the rescue dog before it is placed in a permanent home.

The foster home will make an effort to assess the rescue dog in terms of:

General health - coat condition, skin problems, weight, energy level.

Behavior - is the dog housebroken (very important); does it know basic commands, does the dog chew, get along with children, men, women,  other dogs, cats.

Temperament - is the dog friendly, withdrawn, or easily frightened; does the dog respond to you

1. All dogs placed in foster care must be crated or baby gated in a seperate room when not supervised until the foster home can make a confident evaluation of the dog’s temperament and behavior while left alone and with people. They must be isolated from any other dogs in the home until a veterinary examination and inoculations have been provided. Pom Haven will supply a crate and or baby gates if needed.

2. If, upon arrival, the foster home suspects the dog may be aggressive, the foster home is to immediately contact Pom Haven.

3. Pom Haven will not be responsible for any damage caused by a foster dog whether damage is to personal property or any other animal, including the Pom Haven Rescue dog. You agree to provide a healthy, stable, loving and safe environment for the rescue dog, preferably until the dog is adopted into a permanent home. While there is no established time parameter a dog will be in Foster care, the Foster Home should not plan to foster a dog for at least three weeks prior to any vacation.

4.The foster home should contact Pom Haven if any medical treatment is needed for the dog.  This should be done prior to performing the treatment.  If treatment is given on an emergency basis, Pom Haven must be notified as soon as possible.  Pom Haven will only pay for those treatments authorized by Larry or Lori Markowski.  In the case of a medical emergency, the dog should be taken to the nearest veterinary clinic or the nearest emergency veterinary clinic if after regular hours.  Notify Pom Haven as soon as possible.

5. Pom Haven Rescue does not pay for dog food while the dog is in foster care unless otherwise specified.  We suggest holistic high quality foods.

6. Any medical or behavioral problems in the rescue dog should be reported as soon as possible to Pom Haven.

7. Pom Haven reserves the right to evaluate the living conditions of the dog at any time and you agree to surrender the dog if said conditions are not found to be satisfactory.

8. You agree not to sell, trade, abandon, or dispose of the dog/puppy in any way, but to immediately notify Pom Haven if you cannot keep this dog as a foster.

9. The foster home understands that this is not an adoption and the dog is property of Pom Haven.  Should the foster home decide to adopt the dog, they will have to do it separately and go through the established procedures.

10.  I acknowledge that there are many risks associated with being around dogs, including the risks of being bitten, scratched,  jumped upon, knocked over, chased, tripped, infected with a disease, injured, or frightened, and I voluntarily assume such risks on behalf of myself, my children, and my guests.  Despite my knowledge of these risks, and despite the fact that I understand that these risks might arise out of the negligent handling of animals by Pom Haven, I have voluntarily agreed to participate in the Pom Haven foster program, and fully accept the risks that go along with that participation.  With these risks in mind, I agree to waive, release, and covenant not to sue over any and all rights or claims for damages which I or my heirs may have against Pom Haven, it’s owners, coordinators, or volunteers arising from any property damage or personal injury which I, my children, or my guests or any third party might sustain as a result of participating in the fostering process, even though such rights or claims might arise out of the negligence of Pom Haven, its owners coordinators, volunteers.  This waiver is binding upon my self, my children, and my guests and or third parties.  I agree to inform my family, guests and any third parties of the existence and contents of this waiver.

11. I agree that under no circumstances will any dog placed in my care be housed outdoors or in an unheated area. 

12. I agree that under no circumstances  are any dogs to be placed on a runner or tie out.

13. I agree that invisible or electric fencing does not prevent other dogs from entering the yard and causing injury, harm, and death to Pom Haven's rescues and therfore will not be used with any dogs I may be fostering. 

Date: _____________ Signed: _________________________________

Pom Haven would like to thank all of its volunteers for making a difference in a rescued dog’s life

Together we can make a difference one dog at a time!