Therapy Dog Program Volunteer Application

First, About our Goal-Directed Therapy Programs

View or download the PDF file below to learn about our dog therapy programs all around San Diego County.

Pawsitive Teams' Goal-Directed Therapy Programs

Therapy Dog Program Volunteer Application

IMPORTANT NOTE: Certification with Pawsitive Teams’ Therapy Dog Programs only pertains to your volunteer work during Pawsitive Teams-sponsored activities. Our liability insurance will not cover you during any other therapy-related programs or activities.

The person who accompanies the dog on Pawsitive Teams therapy visits must complete this form. If you’re not the owner, you must provide written proof of permission to handle this dog.

After completing the entire form, don’t forget to click on the SEND button at the end.

Preliminary Information

Applicant Information

Owner's FIRST AND LAST NAME*

Handler's FIRST AND LAST NAME*

Address*

City*

Zip*

Home Telephone*

Mobile Telephone*

Email*

Emergency Contact's Name*

Emergency Contact's phone*

Handler's education: Please tell us a little about your educational background. Include any relevant training, vocational schools, workshops, etc. Indicate Emphasis and/or Major

Employment: Enter information about your employment history starting with your current or most recent job and include a description of your duties and length of time with that employer/position

References: Please give us the names of two personal or business contacts who can act as references on your behalf (no family members). Include person's name, daytime number and relationship.

Reference #1 Name

Phone

Relationship

Reference #2 Name

Phone

Relationship

Do you belong to any clubs or organizations?

YesNo

What organizations do you currently volunteer for or have volunteered for in the past?

Where/how did you acquire your dog companion?

How long have you had or known this dog?

What training has your dog had?

Do you train with Operant Conditioning methods (i.e. positive reinforcement & clicker training)?

YesNo

Are there any environments that your dog avoids or may cause stress?

Are you and your dog certified with any therapy dog organizations?

YesNo

If yes, please give details and name of organization(s)

Dog Information

Dog's Name

Dog's Age

Date Of Birth

Breed and Description

Gender

FemaleMale

Spayed or Neutered?

YesNo

Dog’s City License Current?

YesNo

What is the dog's license number?

Therapy Dog Program Volunteer Application

First, About our Goal-Directed Therapy Programs

Therapy Dog Program Volunteer Application

Preliminary Information

Applicant Information

Dog Information

Behavioral Information