FOSTER

Do you have other pets living in your home? *

Yes

No

Please list the ages, species, and breeds of other pets living in your home

Please list anyone who lives in or regularlgy visits your home. (Name, Age, and Relationship)

Is there anything special that we should know about your home?

Landlord email (if applicable):

Landlord Phone:

Landlord Name:

Do you... *

own your home?

rent your home?

rent with pet approval from you landlord?

How would you describe your home? *

House

Condo

Duplex

Apartment

How did you hear about us?

Cell Phone:

What is the best way to contact you? *

Home Phone

Cell Phone

Email

Work Phone

Direct Supervisor:

Employer: (Please include phone number)

Email:

Name: *

Address

Home Phone: *

Name and Phone Number of Personal Reference: *

As a Foster... *

I agree to permit a representative of SAMS to visit my home and observe where the foster animals will be kept.

I agree to keep foster pets separated from my personal pets if recommended by SAMS veterinary staff.

Upon SAMS request, I will return pet within 24 hours.

I agree to foster the pet for the length of time deemed necessary by SAMS in order for them to be placed up for adoption.

I agree to call and schedule A time to return animal to SAMS once they are ready to be adopted.

If foster is sick, I will contact SAMS, and if necessary, bring to Brown Animal Hospital for -medical exam/treatment. (or Tri-County Emergency Clinic if Brown Animal Hospital is closed)

I will assume all financial responsibility if I take foster to any veterinarian other than Brown Animal Hospital or other clinic as directed by SAMS staff.

Food, Litter and other expenses incurred will be my responsibility. SAMS will provide these when available.

I agree to follow the recommendations of SAMS and its consulting veterinarian in case of extreme behavioral or health issues.

Veterinarian Name and Phone Number: *

Are the animals in your home current on all vaccinations?

Yes

No

Are there any known allergies in your home?

Is there a time of year that you cannot foster? (Please describe) *

Are the animals in your home spayed/neutered?

Yes

No

Name and Phone Number of Personal Reference: *

stray animal midway shelter

FOSTER HOME APPLICATION