Facility Dog Application

Page 1


Contact Us
Please contact ECAD to obtain a link to the correct application form.  Call 860-489-6550 or email clientsupport@ecad1.org. Do not complete this application.

Page 2

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 









Facility Primary Contact (all communications will be directed to this person)









This will be used to identify a Facility Team unit and MAY be the same as the Facility Name above. Example: Mercy Hospital or Pediatric Wing



School District, Hospital Network, County, etc.


Additional Information

If you feel you need more than 3 handlers, please contact Customer Support at 860-189-6550 ext:526

Signature