Animal Assisted Psychotherapy Consent Form

Animal Assisted Psychotherapy Consent Form

Please read carefully and provide your consent for participation in animal assisted psychotherapy sessions.
Animal Assisted Psychotherapy involves interaction with trained therapy animals to support your mental health treatment. While every precaution is taken to ensure safety, there may be risks such as allergies, animal behavior unpredictability, or other unforeseen events. Please read the following carefully before providing your consent.
Full Name of Participant*

First NameLast Name
Age of Participant*
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Please list any allergies, medical conditions, or concerns related to animals that we should be aware of.
Emergency Contact Details (Name, Relationship, Phone Number)*
I acknowledge that I have been informed about the nature of animal assisted psychotherapy, including potential risks and benefits.*

I agree
I give my consent to participate in animal assisted psychotherapy sessions with trained therapy animals.*

I agree
Signature of Participant or Legal Guardian*

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Date of Consent*

MonthDayYear
Date
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