Assisted Therapy Dog Adoption Application – Companion Paws Therapy Dogs

Skip to content

La Fondation LifeLine Canada
Reprendre Votre Chien
Contactez-Nous
Etre Implique
Faire une Contribution
S’identifier
English

Pattes D’Accompagnement
Adoption de Chien de Thérapie Personnelle
Adoption de Chien de Thérapie Assistée
Certifiez Votre Propre Chien
Chien de Thérapie en Visite

Search for:

Assisted Therapy Dog Adoption ApplicationTLC Admin2021-02-24T15:41:10-08:00

Cette application est destinée au programme d’adoption de chiens de thérapie assistée Companion Paws de TLC. Pour les éducateurs, les enseignants, les médecins, les professionnels de la santé mentale, les thérapeutes et les professionnels qui amèneront leur chien de thérapie certifié pour travailler avec eux pour soutenir leurs étudiants, leurs clients et leurs patients.

If you are human, leave this field blank.

Name *

Age *

Email *

Phone *

Address *

Apt, suite, etc.

Country

City

State

Zip code

Please upload a letter stating the date, your profession, location of where the dog will be attending with you and details of what the dog will be doing for your students, clients or patients *

Names, ages, occupation and relationships of all members of household: *

What kind of family home do you live in? *

Single Family

Townhouse

Condo

Apartment

Mobile

Farm

Duplex

Student Housing

Home size (square footage) *

What is the size if your property? *

Do you live in a rental unit? *

Yes

No

If renting, please upload a letter (pdf format) from your landlord stating that permission to keep a dog on the property is granted.

How long have you lived in your home? *

Do you have a fully fenced yard? *

Yes

No

Please describe size, height and type of fencing. *

If not fully fenced, how will you keep your dog safe while it is outside? *

How would you describe your household? *

Loud

Calm

Busy

Quiet

How much interaction has/have you and your child(ren) had with dogs in the past? *

Does anyone in the home have known allergies to dogs? *

Are you looking for a particular size, sex or age of dog? If so, why? *

Please describe your perfect Assisted companion pet *

What does adopting a rescue dog mean to you? *

Have you previously ever adopted a dog? *

Yes

No

Do you currently have any pets? *

Yes

No

Number, Type and Description of any other pets in the house *

Write N/A if not applicable

Are these pets spayed or neutered? *

Yes

No

Are these pets up to date on vaccines? *

Yes

No

Have you previously owned any pets in the last 10 years (other than any you may have now), and what became of those pets? *

Where do current pets/did previous pets spend most of their time? *

What are you currently feeding your dogs (type of food and brand)? *

Are you capable of caring for a companion animal? (Exercising, walking, feeding, playing, grooming, and training) *

What is the work schedule of the family members, and how long would a dog be in your home alone? *

How and how long do you plan to exercise a dog both on-leash and off-leash? *

Describe your current daily activities. *

Where will the dog spend the day? *

Where will the dog spend the night? *

Number of hours (average) dog will spend alone? *

What are your thoughts on crate training? *

Under what circumstances would you not keep the dog? *

Divorce

Illness in Family

Going to bathroom in house

New Baby

Moving

Escaping from house/yard

New job

Allergy

New partner allergic / doesn\'t like dog

Chewing

Barking

Dog became ill /high vet bills

Digging

Shedding too much

Being destructive in the house (furniture, shoes, etc)

Dog grew too big

Biting

Kids ignore the dog

Pets didn\'t get along

Not obedient enough

Redeployment

Other

If 'other', please specify.

If you were to move in the future, what would happen to your dog? *

Have you ever surrendered a pet? *

Yes

No

If yes, please tell us why.

Explain how you will be able to manage the training of the dog in accordance to your current work / leisure schedule *

Do you intend to take the dog for regular medical checkups and keep vaccinations up to date? *

Yes

No

Are you willing and able to pay for any future medical needs of your pet which can average $1,200/year? *

Yes

No

Name and contact information of your Veterinarian/Clinic you will be using

Do you agree to provide regular health care by a licensed Veterinarian? *

Yes

No

Do you agree to keep the dog as an indoor pet? *

Yes

No

Have you talked to all of the people in your household about adding a dog to the household, and do they agree? *

When traveling/away from home, what arrangements will you make for the care of your dog? *

Are you prepared to make the 10-15 year commitment a dog requires? *

Yes

No

Are you willing to let a representative of Companion Paws or the Rescue have a home visit by appointment? *

Yes

No

Any additional information you would like to add?

Reference #1 (Name, phone number and relationship) No more than one relative or family member *

Reference #2 (Name, phone number and relationship) No more than one relative or family member *

Reference #3 (Name, phone number and relationship) No more than one relative or family member

Menu

La Fondation LifeLine Canada
Reprendre Votre Chien
Contactez-Nous
Etre Implique
Faire une Contribution
S’identifier
English

©2019 The LifeLine Canada Foundation. All rights reserved.