The information provided in completing this profile will enable OPHS to find the most satisfying foster animal and experiences for you. Please be sure to complete all sections of the profile thoroughly and as honestly as possible. 1 Start 2 Page 2 3 Page 3 4 Page 4 5 Complete Name * Email * Primary Phone * Street Address * City * State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * Do you: * - Select -OwnRent Please Provide Landlord Name * Landlord Phone * How many adults live in the home? * How many children live in the home? * Children’s ages Are all household members familiar with dogs? * - Select -YesNo Does anyone in your home have allergies to dogs? * - Select -YesNoPlease list the following information about pets currently living in your home:Species - Breed - If dog, size in pounds - Age - Male/Female - Spayed/Neutered - Date last vaccinated - Have they lived with other animals before? All Current Animals * How would your pets interact with a foster dog/puppy? * Next Page >
