Become a Volunteer with our Emotional Support Division (Therapy Dogs)

Handler Name:

Address:

Number of years working with therapy dogs:

Dog Name:

Dog Age:

Dog Breed:

Number of years your dog has been certified:

Veterinary Name:

Medications your dog is taking including flea, tick and heart warm preventives:

Up Loaded image of Rabies Vaccine:

Max. file size: 8 MB.

Certifying Agency:

Insurance company:

Uploaded image of insurance certification:

Max. file size: 8 MB.

Therapy Dog Reference:

Please include at least two people you have worked with in your volunteer therapy dog career

Name:

Employment:

Connection:

Years known:

Phone Number:

Email Address:

Are you willing to go through a background check?

YES

NO

Once you have filled out this form we will review it and be in contact with you to arrange the next steps. We appreciate your interest and we are looking forward to meeting you and your dog

Become a Volunteer with our Emotional Support Division (Therapy Dogs)

Become a Volunteer with our Emotional Support Division (therapy dogs):