Coco’s Heart Incident Report

We are sorry to hear there has been an incident with your foster dog and appreciate your willingness to submit an incident report. We take the safety of our foster dogs as well as any personal pets in your home very seriously and having this form on record will help keep our CHDR staff in the loop as well as come up with a plan moving forward to hopefully avoid things like this happening in the future. We know they are unintentional and can be very emotional situations so we looking forward to working together as team moving forward!

Name of Foster

First Name

Last Name

E-mail Address

Name of Foster Dog involved in Incident

Please provide the name they have in rescue.

Date of Incident

YYYY

Date Incident Report is submitted

YYYY

Incident Location

Where did the incident take place at?

Has your foster dog been seen at the CHDR vet clinic yet? (This does not include their welcome care when they first arrive to rescue).

How long have you been fostering/temp fostering the dog when the incident occurred?

Does this foster dog have a current pending adoption?

Pending adoption means you have been connected by our Adoptions Coordinator to an applicant.

Yes

If yes, is the applicant informed of this incident?

Yes

N/A

Please provide who was involved in the incident including ages of people who experienced this.

Please provide an explanation of what happened.

Including description of events before and during, action taken after, etc.