Dog Program Volunteer Interest Form

Questions on this application?

Please e-mail dogprogram@chla.usc.edu

Thank you for your interest in volunteering as a therapy dog team. It takes a special combination of person, dog and commitment to qualify as a CHLA therapy dog team. If you havent already, please review our requirements at here.

Joining the Dog Therapy program is a multi-step process. First, complete the interest form below. We will respond with appropriate information on how to proceed with training, the Pet Partners course, the dog-and-handler evaluation, and the final CHLA Application. Please note there is no need to complete an application until after you and your dog have passed a Pet Partners evaluation.

New User Details

User ID

User ID (verify)

Password

Password (verify)

* First name

Middle name

* Family/last name

* E-mail

* Phone (Home)

* Phone (Mobile)

Your Dog's information:

* Your Dog's Name

Dog's Gender

Is your dog spayed/neutered?

* Dog Breed

* Dog Age (years)

Dog Date Of Birth (if known)

* How long has your dog lived with you?

Does your dog like meeting meeting new people?

Feel free to explain:

Is your dog gentle and calm around children?

Feel free to explain:

Is your dog comfortable being touched on all parts of his/her body?

Feel free to explain:

What obedience training has your dog had?

Can your dog reliably do the following on the first or second command without treats?

Sit

Down

Stay

Come

Walk on a loose leash

Has your dog ever shown aggression to another person or another animal?

Feel free to explain

Are you willing to be a registered Pet Partners Team? (All our dog volunteers are registered with Pet Partners. More info can be found here.

Are you already a registered team with Pet Partners?

If already a Pet Partners team, what is your qualification?

If already a Pet Partners team, do you have any special qualifcations?

How did you hear about us?

If 'other' is selected please list below:

Why would you like to be part of the Dog Therapy Program?