Animal Therapy Request

Animal Therapy Request

In adherence to our mission services can only be provides to facilities who meet one of the following criteria. 1). Students with IEP or 504 Plan 2). Adult Day Program with members having a current PCSP 3). ABA center/preschool. NO IN-HOME VISITS
Contact Person*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Format: (000) 000-0000.
Facility Name*
Type of Facility*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
WeeklyMonthlyQuarterlyOne time visitOther
How many students/members are enrolled? (minimum of 15 required)*
What is your facility goal for Animal Therapy?*
By submitting this request, you understand that not all submissions can be fulfilled. New facilities are added to our program based on the availability of Therapy Teams. Pawsitive Friendships can make no guarantee of specific animal species per visit. All facility staff are expected to actively participate in Animal Therapy and manage the behaviors of students/members at all times. If Animal Therapy becomes available in your area, a Program Coordinator will contact you to set up an appointment to tour your facility to ensure we are a good fit and review the expectations of Animal Therapy for both parties. All Animal Therapy services have an associated fee to cover the cost of supplies and insurance.
Should be Empty: