Visiting Therapy Dog Requests

1

Do you know of a group that would like to meet one or more of our wonderful certified Companion Paws visiting therapy dogs?

TLC’S Companion Paws Visiting Therapy Dog Program offers therapeutic visits to groups for those needing the care and comfort of our trained and certified therapy companions. At this time we are not able to do individual visits in private homes.

Please complete the Visiting Request form below and we will respond with Companion Paws Visiting Team(s) availability.

Visiting Therapy Dog Request

First Name *

Last Name *

Phone Number *

Email *

Name of Facility *

Facility Address *

City *

Province *OntarioQuebecBritish ColumbiaAlbertaManitobaSaskatchewanNova ScotiaNew BrunswickNewfoundland and LabradorPrince Edward IslandNorthwest TerritoriesYukonNunavut

Postal Code *

Facility Website / URL

Facility Type *

• Education (ex: school, college, library)
• Family/Community Services (ex: camps, Support groups)
• Healthcare (ex: hospital, rehab, skilled nursing)
• Hospice
• Justice System (ex: correction center, courthouse, police station)
• Residential (ex: senior housing, group home)
• Special Event (ex: mental health awareness, de-stressing event)
• Other

Dates and Times of Visiting Request(s) *

Visit / Event Type Details *

Age of Persons Receiving Visits (check all that apply) *

• Children
• Adults
• Seniors

Level of Staff Involvement During Visits by Therapy Dog Teams (check all that apply) *

• Active (high activity, many distractions, routinely unanticipated interactions, volatile setting)
• Moderate (some activity and distractions, occasionally unanticipated interactions)
• Quiet (low activity, routine interactions, predictable setting)

Client's Participation per Interaction (check all that apply) *

• Individual
• Small Group (less than 5)
• Medium Group (5-15)
• Large Group (more than 15)
• Extra Large Group (more than 40)

How many Visiting Teams are you requesting for your event? *

• 1
• 2
• 3 +

Is this a one-time or recurring volunteer opportunity? *

• One-Time
• Recurring

Details and Description (Please describe your opportunity for prospective volunteers visiting teams. This would include information about your facility, special event, the persons in attendance and any special requests) *

Meeting Spot for Visiting Teams (Please detail who will meet our team(s) and where the meeting spot for visiting teams will be upon arrival, to be escorted to the visiting area) *

Submit