Behavior & Medical Disclosure

This disclosure is required by the Colorado Department of Agriculture for all incoming foster dogs with known behavior/medical concerns.

Date

MM slash DD slash YYYY

Anticipated Arrival Date

MM slash DD slash YYYY

Foster's Name

Foster's Email

Dog's Name

First

Origin

Concerns

No known medical or behavioral concerns noted.

Known Medical/Behavior issues:

Consent(Required)

As required by the Colorado Department of Agriculture, MHCR is disclosing known behavior or medical concerns related to the aforementioned dog. We are required to have written consent of your desire to foster the dog described herein as evidenced by a return email acknowledging the behaviors disclosed on this form. Additional behaviors, currently unknown, and/or medical conditions may be encountered once the dog has arrived. As disclosed within the foster agreement, common risks associated with dogs transferred in from shelters/rescues include fleas/ticks, worms, diarrhea (stress, coccidia, giardia, etc), kennel cough, parvovirus, and distemper. These diseases/issues may not show up when the dog presents for a health certificate prior to travel.(Required)

Consent(Required)

I understand I have 7 days to decide if I would like to adopt my foster dog. I agree to let Jenni know BEFORE the dog is posted for adoption.(Required)

Consent(Required)

I agree to contact all potential adopters I am tagged on within 48 hours of said tag, regardless of where they are in the approval process.(Required)

Consent(Required)

I understand potential adopters are to be given equal consideration until I’ve notified the admin that I would like to stop accepting future applications.(Required)

Consent(Required)

I understand all medical records need to be collected & filed and I MUST fill out the medical care/medication administration PRIOR to records being provided to an adopter AND before an adoption takes place.(Required)

Consent(Required)

I understand when an adopter is chosen, I am to provide them with the link to the dogs entire medical record folder and not just the dogs spreadsheet summary.(Required)

Signature(Required)

Date(Required)

MM slash DD slash YYYY