Facility Update Form

As a Good Dog Partner, we need your help updating our records and making sure we understand your facility's client or patient environment. Your input will help us best prepare the highly trained and certified volunteer therapy dog teams we provide for you.

Your input remains strictly confidential. We do, however, use aggregate data, gleaned from all our partners, to inform funders of the value of our free services to partners like you...another reason for your help in keeping our data accurate.

Please take a few minutes now to complete this form. We appreciate your response and continued partnership.

Facility Information

Official Facility Name *

Website

Facility Address *

City *

State *

Zip Code *

How did you hear about us? *

Contact Information

Please provide details of a contact at your facility that our Visit Coordinator will be able to reliably communicate with in order to schedule visits, confirm availability, as well as update your facility information.

Primary Contact Person

First Name *

Last Name *

Title *

Email Address *

Phone Number * 🛈

Secondary Contact Person

First Name *

Last Name *

Title *

Email Address *

Phone Number * 🛈