Expression of Interest – Companion Dog Programme

This is a simple starting point to help us understand a little about you and your situation, and whether our Companion Dog programme could be the right fit for you.

Before you go any further, there are a few important things to know: Companion Dogs are home-based dogs - they do not have public access rights. They are placed with individuals or households where there may be an ongoing non-complex health need, and where the dog will provide companionship, calm and support, and a sense of purpose within the home.

At this time, Companion Dog placements are available in Auckland, and Waikato only.

If this sounds like the right fit for your situation, we'd love to hear from you. Please share as much as you feel comfortable with.

Before you complete this form, please visit our website to read about the Companion Dog Programme - it may answer some of your questions before you begin.

Is there anything from the website you’d like to ask more about?

Full Name

First NameLast Name

Email Address

example@example.com

Phone Number

Area CodePhone Number

Best time and way to contact you

Town/City and region

Tell us a little about your situation and why you are interested in a Companion Dog.

You can share as much or as little as you feel comfortable with. For example: who lives in your household, any health circumstances that are relevant, or what led you to reach out to us.

Do you have any other pets?

Please state what other pets

Who lives in your household?

How do you feel a Companion Dog might help you or your household?

For example: companionship, routine, emotional support, motivation, or something else entirely.

Do you own or rent your home?

Do you have previous experience with dogs?

Do you have a securely fenced outdoor area?

Is there anything else you feel is important for us to know?

Before you go, we'd love to know… how did you come across the Mobility Dogs Companion Dog programme?

Please tell us how you heard about us

Does anyone in your household have an allergy to dogs?

Thank you for sharing this information with us. Our team will take the time to review the information you’ve shared and will be in touch once we’ve had a chance to determine whether we are able to support you. If your needs align with our programme, you may be invited to complete a full application. If we’re unable to assist, we will let you know.

Ngā mihi & thank you,

The Mobility Dog Team 🐾

How can we help? Let’s get started