Schedule A Visit

Requestor Name*

First NameLast Name

Requestor E-mail*

Requestor Phone Number*

Is the person requesting the visit also the on-site coordinator?*

On-Site Coordinator Name

First NameLast Name

On-Site Coordinator E-mail

On-Site Coordinator Phone Number

Name of the location being visited*

Address for the Visit*

Street Address

Street Address Line 2

CityState

Postal / Zip Code

What type of location is this visit request being made for?*

Location Website (if available)

If 'Other', please provide some detail about the visit location

If you can give us a sense of what you'd like from your pet visit, it will greatly help us select the right pets for you*

Are you looking to have pups, cats, or both, join on your visit?*

DogsCatsBoth

Where will this visit take place?*

IndoorsOutdoors

If this is an outdoor visit, please describe the area where the visit will take place:*

If this is an indoor visit, please describe the area where the visit will take place:*

If outdoors, do you need us to bring a temporary barrier fence?

YesNo

How Many Pets Would You Like Us to Bring to the Visit*

And just a bit of guidance....we recommend at least two pets for every visit--people just like different pets...and for larger visits, a ratio of 1 pet for every 3 persons who will be engaging at any given point in time.

Date*

Date

Time*

Hour Minutes

AM/PM Option

Length of Visit in Hours....Half Hour increments acceptable, but the minimum length of a visit is 1 hour.) If Longer Than 2 Hours, the Pets Join in Shifts *

Fees for Visit Based Upon Number of Pets, Length of Visit, and fee of $40 per Pet/Hours of Visit

Would you like this to be a regularly occurring visit?*

If a regularly occurring visit, please tell us the frequency

for example, every Tuesday, or every 1st and 3rd Saturday

Download a Copy of the Paws-to-Share Certificate of Liability Insurance for Your Records

If you require your site to be added to the Certificate please tell us the exact format it should be added as

Download a Copy of the Paws-to-Share W9 for Your Records

To ensure every visit is safe, enjoyable, and successful—for participants, pets, and handlers alike — the following responsibilities must be met by the host site:

Provide a suitable visit space that is clean, free of debris or hazards, and large enough to accommodate participants and therapy teams comfortably.

_____________________________

Designate a site lead to be present throughout the visit to oversee activities and assist as needed.

_____________________________

Share contact information for the site lead, who will serve as the primary point of contact for the Paws-to-Share team.

_____________________________

Ensure an appropriate environment:

If other activities are taking place, locate therapy pets away from loud noises (e.g., music, microphones, or announcements).

In the event that other animals are involved in site activities, Paws-to-Share pets must be kept well separated to ensure safety and comfort for all animals.

If food is being served, place the therapy teams in an area far enough away to prevent distraction or interference.

_____________________________

Provide alternate indoor or shaded locations in case of extreme temperatures or rain.

_____________________________

Obtain parent/guardian permission for participating students, when applicable.

_____________________________

Arrange convenient parking close to the visit location, including accessible (handicapped) parking for handlers as needed.

_____________________________

Cover parking fees or provide passes if required for access to the site.

_____________________________

If fencing is necessary, site personnel should help with both setup and takedown.

_____________________________

Notify Paws-to-Share of cancellations at least 24 hours prior to the scheduled visit by contacting a Paws-to-Share management team member.
ent team member.

Please sign below to confirm that you have read, understand, and agree to uphold the site responsibilities outlined above.*

Date Signed*

Date

Thank you so much for your interest in having Paws-to-Share join with pets in hand--or paw is probably more appropriate. We will be back in touch shortly to get all the details worked out, and to get the visit coordinated. Thanks again.

The Paws-to-Share team

Schedule A Visit

Date, Start Time, and Length of Visit

Certificate of Liability Insurance and W9

Responsibilities of the Site for Animal-Assisted Therapy Visits