Open Doors-Facility Dog Application

Are the Director of the facility and the infection control person (if applicable) in favor of having a therapy dog? If not, please gain this approval prior to completing this application. ECAD can help by providing testimony from facilities that are benefiting from an ECAD Therapy Dog. People from these facilities can also explain how they are handling infection control issues. Once ECAD has agreed to service the applicant, the Facility Dog Agreement will be sent for signature and a training date will be set. 
Prequalification 
Yes No
Facility/Organization Information











Contact Person








Additional Information


Signature


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