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Southwest Canine Corps of Volunteers, Inc.

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Facility Visit Request

Interested in a SCCV facility visit? Please fill out the form below.

SCCV Facility Visit Request

Facility or Business Name

Contact Name

Email

Facility Address

Phone

Facility City

Facility State

Facility Zip Code

Approximately how many people would the dogs be visiting?

Do you envision individual visits with the dogs or would the dogs be visiting in a group setting?

Please check the needs and/or challenges the people at this business or facility are facing. Check all that apply.

Elderly

Children

Learning challenges

Ill or injured

Stress

Emotional support needs

Physical rehabilitation

Addiction

Other

Briefly describe how regular therapy dog visits will benefit your organization.

Thank You for submitting! You will be contacted soon regarding your request.

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