Facility Visits Request Form

Are you interested in having Love On 4 Paws conduct therapy dog visits at your facility? Here are a few things to know about Love On 4 Paws first:

a typical visit is one person with one therapy dog, for 1-1/2 hours total.
we request that other dogs except service dogs not be present (for insurance reasons)
we request close, convenient, and free parking for our volunteers
we request you honor our existing hospital health clearances*
if your facility can help offset our costs, it will be deeply appreciated

To begin the facility visits application process, please complete and submit the following form. A Love On 4 Paws representative will contact you within 5 business days.

Items marked with * are required.
*Facility Name:
*Address:
Suite:
*City:
State:CA (LO4P is located in Southern California.)
*Zip:
Contact Person
*First Name:
*Last Name:
*Business Telephone:() -
Business Telephone Extension:
Cell Phone: () -
*Email:
*Facility Type: (example: "hospital", "school", "assisted living facility", etc.)
*Typical People Visited: (example: "staff", "children", "sick/injured", "seniors", etc.)
*Visit Scenario Planned: (example: "1 on 1 in small room", "group with an escort", etc.)
*Number of Individuals Wanting Visits per Day: (estimate)
Number of Visits per Week: (estimate)
How / Where did you Hear about Love On 4 Paws?
Other Comments: (Why are you interest in Love On 4 Paws, unique facility aspects, etc.)
*About Health Clearances: All Love On 4 Paws volunteers obtain yearly health clearances from a major hospital in the Los Angeles area. We maintain records and make them available online to those facilities we visit. Since many of our volunteers visit at multiple hospitals, we cannot ask them to get multiple TB tests every year. If your facility has other specific health-related requirements, please share them in the comments section.
Items marked with * are required.
Your IP Address: 3.149.28.19

Facility Visits Request Form

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