SELF-SCREENING FOR THERAPY DOG WORK

Self-Screening Questionnaire

Thank you for your interest in Ottawa Therapy Dogs! Working in canine-assisted interactions is a complex and demanding kind of volunteering, but it offers incalculable rewards for those people and dogs who are well-suited for it. For example, people are often surprised at the commitment required—both in time and finances. They are also often surprised that, while all dogs are wonderful personal and family therapists, very few actually desire to provide this service to unfamiliar people in strange places on a regular basis.
Please take this self-assessment to determine if both you and your dog may be suited to therapy dog work.

THIS IS NOT AN APPLICATION.
Your Name:*

First NameLast Name
Your email: *
example@example.com
ABOUT YOUR DOG

Please rate your dog in each of the following areas.
My dog...*

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2

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5

1 is Is never interested in meeting or being with strangers, 5 is Always, consistently and actively seeks out the company of people who they have not met before.
My dog...*

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5

1 is Is extremely high energy and hyperactive, 5 is Is extraordinarily calm, mellow and relaxed
My dog...*

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1 is Is afraid of anything and everything outside of their normal, familiar environment. , 5 is Quickly adjusts to all new environments, sounds, strangers etc with no problem.
How often has your dog had significant interactions with people outside of our home? *

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1 is Never , 5 is Several hours each day.
What does your dog do when he meets someone new? *

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1 is Very shy, avoids contact, 5 is Eager to make a new friend
When a stranger pets my dog they... *

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1 is Turn away, hide or gives other signs they are not comfortable., 5 is Eagerly accepts the attention and welcomes continued engagement
My dog responds to my cues for obedience no matter what environment we are in. *

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1 is Never , 5 is Always
How often does your dog paw at people? *

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1 is All the time! , 5 is Never
How often does your dog jump up on people? *

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1 is All the time! , 5 is Never
How often does your dog lick people? *

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1 is All the time! , 5 is Never
How often does your dog vocalize - whine, bark, "talk" etc when outside of your home?*

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1 is All the time! , 5 is Never
How does your dog behave at the veterinarian? *

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1 is Nervous, shaking, pacing, panting etc., 5 is Calm, cool, collected
How does your dog behave at the groomer? *

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1 is Nervous, shaking, pacing, panting etc., 5 is Calm, cool, collected
How does your dog react when seeing another dog?(Choose #3 if your dog always wants to play with other dogs) *

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5

1 is Growls, snarls, lunges, 5 is Mildly curious, but still pays attention to me.
Select the obedience skills that you and your dog have developed to a "CONSISTENTLY RELIABLE LEVEL"

SitDownStayStandCome when calledLeave itWalking on a loose leashNOT jumping up on people
Select the obedience skills that you and your dog have developed to a "SOMETIMES" LEVEL

SitDownStayStandCome when calledLeave itWalking on a loose leashNOT jumping up on people
Select the obedience skills that you and your dog have NOT YET developed.

SitDownStayStandCome when calledWalking on a loose leashLeave itNOT jumping up on people
Is your dog fed a raw diet? (Raw food diets are not permitted for therapy dogs so you would need to be willing to transition your dog's diet in order to be a therapy dog team).*

YesNo
ABOUT YOU

Please rate yourself in each of the following areas.
Do you have the time to work with your dog regularly to train and maintain the behaviours necessary for making safe therapy dog visits? *

1

2

1 is No , 2 is Yes
Do you have the time to commit to thoroughly grooming your dog prior to every visit, (or the means to pay for professional grooming)? This also includes bathing when necessary - when the coat no longer looks or feels clean or is malodorous. *

1

2

1 is No, 2 is Yes
With my dog...*

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5

1 is I use a firm, no-nonsense tone of voice and leash corrections to make sure they know I am boss, 5 is I use a conversational tone of voice and/or hand signals to work with my dog as a partner.
With my dog...*

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1 is I am often confused about what my dog's behaviour means., 5 is I clearly understand what my dog communicates through their behaviours.
I am always willing to learn from others and am accepting of constructive feedback.*

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3

1 is Never, 3 is Always
Can you commit to consistently making scheduled visits (weekly or bi-weekly) for at least one year?*

YesMaybeNo
Are you available AT LEAST ONE WEEK DAY between 9 am - 5pm to volunteer on a regular basis?*

YesNo
Unlike many kinds of volunteering, there are fees associated with becoming a registered Ottawa Therapy Dog team. They include:

Evaluation Fee: $30

Registration Fee / Annual Membership Renewal: $45

Costs associated with travel to your placement - These are the responsibility of the volunteer. Costs will vary, but parking will always be covered by the facility that you are visiting or OTD. We will strive to find a placement within a driving distance that is suitable for you.

Veterinary Fees: These are the responsibility of the volunteer. An annual negative fecal test result is necessary to remain registered with OTD so that may be an additional cost to factor into your vet expenses. (Cost seems to vary from $65 - $100 for the fecal test)
Are you willing to pay fees to OTD and to your vet to volunteer?*

YesNot sureNo
Score out of 87:
By clicking on the submit button, you will receive an email that provides you with your scoring information. A copy will also be submitted to Ottawa Therapy Dogs and we will keep it on file.

We will not contact you unless you ask us to do so after watching the videos and reading the information and instructions on the "Volunteering With Your Dog" page of our website.

Don't forget to go back to our website to complete the pre-requirements before you contact us to apply!

Thank you!
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Self-Screening Questionnaire

ABOUT YOUR DOG

ABOUT YOU