Health Heelers
Professional Therapy Dog Service
Name
Address
City
State
Zip Code
Daytime Phone
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Evening Phone
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E-mail Address
Dog's / Cat's name
Age
Breed
Describe experience in health care, education, or working with people with disabilities
List obedience classes or other work or events you have done with your dog
What is your dog's reaction to other dogs?
Why do you think your dog would make a good therapy dog?
What is your general availability?
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