REJOICE COMFORT DOG

Name

First NameLast Name

Email

example@example.com

What is the physical address of the location that the visit will take place at?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Name and phone number of alternate contact, if different than listed above:

Date Request - Please note this is only a request and cannot be guaranteed.

Date

Start Time Request - Please note this is only a request and cannot be guaranteed.

Hour Minutes

AM/PM Option

End Time Request - Please note this is only a request and cannot be guaranteed.

Hour Minutes

AM/PM Option

Please tell us a little bit about who we will be visiting with:

What type of visit will this be?

Please tell us a little about the location of our visit to the best of your knowledge - The type of business/church, the size and set up of the room, if the room has chairs/tables/couches. Is the floor carpet or tile. Classroom, day room, private home, etc.:

Will the visit be located indoors

All outdoor visits are weather permitting and may be cancelled if conditions are deemed unsafe for Rejoice. Outdoor visits can only proceed if Rejoice and her team are kept in a cool, shaded area at all times. If weather conditions are not suitable and an indoor alternative is not available, the visit may need to be rescheduled (if the location is indoors, please skip this question).

If the visit will take place outdoors: Please give a detailed description of where the outdoor area that your visit will take place.

Please give details about where our team should park:

Please give a brief description of the building/door our team should enter with Rejoice. Please include directions of where the team should go once inside to meet with our contact:

Is there a special reason for your visit:

Name and phone number of contact the team can meet in person with upon arrival:

How many people do you expect to interact with Rejoice during the visit:

Are there any other animals at the location that Rejoice will be visiting:

If so, please give additional information about any other animals that will be on the property during Rejoice's visit:

Is there any other information you can share with us about your visit to help us to give you the best experience possible:

Will you need us to provide the following prior to our visit:

How did you hear about us:

Please be advised that LCC K-9 Comfort Dog Rejoice and her team may be called upon to respond to emergencies at any time. In such cases, previously scheduled visits may be canceled with little or no notice.

We appreciate your understanding and flexibility.

The LCC K-9 Comfort Dog Ministry never charges for its services.

Once your form has been received, you will be contacted by Rejoice's Top Dog to finalize the details, date, and time of your visit.