HABIT School Program Monitoring Form

Date *
Time *
Monitor *
Volunteer's Name *
Dog *
School *
Grade *
Teacher *

Assessment of Classroom Climate; Overall behavior of Children



Is there another Animal in the classroom? (if yes, explain)

Yes No


Where are visits located in the classroom?


Is the space adequate for the visit? (if yes, explain)

Yes No


What is the dog's reaction to the children?


How engaged is the Volunteer and the dog with the children?


Does the Volunteer have adequate control of the dog? (if no, explain)

Yes No


How is this control maintained?


Is the Volunteer being an advocate for their dog?
(for example not allowing children to be in the dog's face, or hugging too tight)


Is the teacher and the class ready for the HABIT visit? (please explain)

Yes No


Do you have any concerns?


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