FOSTER PROFILEFosterFosterFoster ProfileFOSTER PROFILE Tell Us Who You ArePlease enable JavaScript in your browser to complete this form.Name *FirstLastPhone *Work PhoneEmail **email address will be used for direct contact by the Foster Coordinator or for communicating general foster pleas to all homes. Your email will never be given out or sold to third parties.Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeMailing Address if Different Than PreviousAddress Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWhat kind of pet are you interested in fostering? *Adult CatsKittens (5-8 weeks)Orphaned kittens (up to 5 weeks)Nursing cat w/kittensInjured or ill catCat Behavior modification/socializationFarm AnimalsAdult dogsPuppies (5-8 weeks)Orphaned puppies (up to 5 weeks)Nursing dog w/puppiesInjured or ill dogDog Behavior modification/socializationSmall or exotic animalsWhat temperament are you looking to foster? *Couch PotatoShyExercise BuddyAlways on the GoLap DogIndependentConstant CompanionNeeds Some TLCPlease list the pets residing in your home. *Name, Breed, Sex, Age, Declawed, Indoor/Outdoor for each petAre the pets in your home spayed/neutered? *YesNoWhat vaccinations are your pets current on? *Pet Name, VaccinationsAre you currently fostering or considering fostering for another organization? If so, who? *Do You Rent or Own Your Home? *RentOwnIf renting, will your landlord allow you to have additional pets? *YesNoIF RENTING: I have talked with my landlord and have done what is required of me to bring a foster pet home. This includes paying any deposits and I have clarified with my landlord any restrictions they have for breeds, size, or number of animals. I understand that if the foster fails based on this, that I may not be allowed to foster from CHHS in the future. *Emergency Contact *FirstLastRelationship *Emergency Contact Phone *Do you have reliable transportation to bring the animal in for check ups and meet & greets with potential adopters? *YesNoIs Your Home: *Quiet with not many visitorsActive and loud with visitorsA little of bothDo you have children that visit your home frequently? *YesNoPlease list gender and ages of residents in the home: *This pet would live primarily: *IndoorOutdoorNumber of hours (average) pet(s) spends alone: *1-2 hrs3-4 hrs5-67 or more Please read and sign agreement *FirstLastBefore you can be approved to foster, your own animal(s) must be current on distemper, parvo, Bordetella, hepatis, parainfluenza, coronavirus, and rabies for canines. Distemper, panleukopenia, rhinotracheitis, calicivirus, and rabies for felines. CHHS will not be held responsible for any transmittable illnesses that your animal may contract. Foster animals may be in your home for one day or several months, all determined on a case-by-case basis. The amount of time is subject to change. As a foster parent you understand that it is occasionally necessary to euthanize animals that have been in foster care for various reasons. This is always a decision of last resort that will not be made lightly. It is required that your foster dog be kept on a leash or enclosed area adequate to contain the animal. Foster dogs are allowed to go on leashed walks; however, they are not allowed to go to dog parks. Fosters cats must always be kept inside. You will have to bring your foster animals back for vaccinations, de-wormers, and flea/tick and heartworm prevention. Do not allow your foster dog or puppy(ies) to have rawhides. However, they can have non-rawhide chews such as pig ears and pork chews. Please feed foster puppies (up to year old) a food that contains at least 27% protein, adult dogs at least 21% protein, kittens (up to a year old) at least 40% protein, and adult cats at least 32% protein. By signing and submitting this form, I affirm ALL of the above information is correct.Please verify that you are human * = Submit