East Texas Horse Rescue & Sanctuary
                                12992 State Highway 21 East
                                         Alto, Texas 75925



                                             Inspection form
Date:_________
Name of Horse_____________________________________ETHRS#______________

Caregiver:
Name ________________________________________________________________

Address_______________________________________________________________

City, State, Zip__________________________________________________________

Home Phone ____________________________Cellphone______________________

Email address__________________________________________________________

Type of inspection:          Adoption           

adopt        3 month                6 month                1 year

Person Inspecting:
Name_________________________________________________________________

Address_______________________________________________________________
City, State, Zip__________________________________________________________

Phone _______________________________________________________________

Cell Phone___________________________

Email address________________________________

Is this a suitable home for the equine?
_____________________________________________________________________
Why or Why not?_______________________________________________________
_____________________________________________________________________


Is the equine located somewhere other than the adopter’s home address?   Y   N
If yes, where?__________________________________________________________
_____________________________________________________________________

Who owns this property?__________________________________________________
_____________________________________________________________________

Any changes in location since the last inspection?______________________________
_____________________________________________________________________

Where will the equine be kept? ____________________________________________
What is the fencing like? _________________________________________________
Type _____________________________ Height ______________________________
How large is the paddock or pasture?________________________________________
What type of shelter will the animal have?_____________________________________

Photographs needed:
Shelter
Feed and feed storage
Fencing
Water Source
Follow up Photographs of Equine:
Equine in paddock or pasture
Full body side
Head
Feet
Front and rear
For follow up inspections:
Is the adopted animal in good health?  Good         Fair         Poor
Explain_______________________________________________________________
____________________________________________________________________

What is the equine being fed?____________________________________________
Current vaccinations?  Y    N   Date of last vaccination__________________________
Current worming?   Y     N   Date of last worming ______________________________
Condition of hooves  ________________ Date they were trimmed last _____________

Please list any comments or concerns on the back of this sheet:
Inspectors Signature_________________________________Date_____________




              copywrite 2004 East Texas Horse Rescue & Sanctuary
                                           Revised 5/4/05