Therapy Dog Visit Request - Mental Health and Wellness - Wellness - Current Students

This form is to be completed by staff, faculty, and student organizations looking to book group Therapy Dog visits. This is not to be completed by individuals looking to meet with one of the dogs. We require a minimum of 3 weeks' notice to book the Therapy Dogs. Please note that we will do our best to arrange a visit, but the more flexible you can be, the better.

Name*
First Last
Email (Carleton Email)*
What is your affiliation with Carleton?*
- Staff Member
- Faculty Member
- Student Group / Organization
Please indicate what department/faculty/student group or organization you are with:*
Please include a brief description of the event / reason you are looking to have the Therapy Dogs attend:*
Please indicate which day you are looking to have a visit:*
Please note: you must submit a request a minimum of 3 weeks in advance.
Date Format: MM slash DD slash YYYY
Please indicate what time you would be looking to have the visit:*

: HH

MM
Please indicate a back-up date or additional date request:
Please note: you must submit a request a minimum of 3 weeks in advance.
Date Format: MM slash DD slash YYYY
Please indicate what time you would be looking to have the visit:

: HH

MM
What location are you looking at hosting the Therapy Dogs?*
Please include any other information that might be relevant (e.g., how many participants you are expecting, any additional dates or times, any other groups present, etc.)