PAT 7
Phone: 01494 569130
Fax: 01845 550236
Email:
[email protected]
Web: www.petsastherapy.org
PETS AS THERAPY
WELCOME ACKNOWLEDGEMENT
(Please give this form to the establishment where you will be visiting)
We shall be pleased to welcome visits from:
Volunteers Details
Title:
First name:
Surname:
Volunteer ID Number.
Address:
Address:
Town:
County:
Postcode:
Name of
Phone Number:
Pet ID No.:
Pet:
Establishment Details
Block Capitals please
Establishment Name:
Title:
Ward Name (if applicable):
Forename:
Address:
Surname:
Town:
County:
Postcode:
Position of Authority:
Phone number:
Email address.
Hospital NHS
Include area code
Hospital Private Hospice
Nursing Home
Local Authority
Nursing Home
Private
Special Needs
School
Main Stream School
EMI unit
Secure Unit
Group Home
Social/lunch Club
Rehabilitation Unit
READ 2 DOGS Infants
Ages:
Please specify
Stroke rehabilitation
Other
READ 2 DOGS - Junior READ 2 DOGS - Senior
0 – 5
6-18
19 – 30 31 – 45 46 – 60
61 – 70
70+
READ 2 DOGS – Special Needs
Residential Home
Local Authority
Residential Home
Private
Play / holiday
club
Adult Mental
Health
- please specify
Number of clients/student
Important note
Please check ANNUALLY the ID of the above volunteer. This ensures that the
volunteer remains a registered volunteer with the charity.
PLEASE TAKE A COPY FOR YOUR RECORDS AND POST, EMAIL OR FAX FORM TO:
Pets As Therapy
Ref.: PAT7
Clare Charity Centre
Wycombe Road
Saunderton
HIGH WYCOMBE
HP14 4BF
Please turn over
Revised 14/01/15
ESTABLISHMENT DECLARATION
Aims and Objectives of Pets As Therapy
The primary aim of Pets As Therapy is to bring temporary but regular animal
companionship and comfort to patients/residents in hospitals, hospices, day care
centres, nursing homes, etc, by means of visits from volunteers and their
registered temperament-tested pets.
Since its beginning in 1983 over 25,000 dogs have been registered into the Pets
As Therapy Charity. Every year some of these retire and new dogs, having first
been examined and passed on health, temperament, suitability and stability
grounds, join Pets As Therapy.
Today there are currently around 5,000 active Pets As Therapy visiting dogs and
108 cats at work in the UK. Every week these calm friendly dogs and cats give
more than 150,000 people, both young and old, the pleasure and chance to cuddle
and talk to them.
As an establishment accepting our service, our volunteers are aware you may
require further references, special police checks or occupational health
interviews and they have declared that they will abide by your policies and
procedures if they commit to visiting there.
Please make sure that you give
our volunteer your Health and Safety procedures and any regulations that you
might require. They have agreed to wear any security badges you require as well
as the Pets As Therapy photo ID and that of their pet.
It is your guarantee
that your visitor remains a registered volunteer of Pets As Therapy and is bound
by its policies.
Pets As Therapy asks that you agree to ensure that your staff treats with
respect and dignity the volunteers and their PAT dogs/cats while at your
Establishment. They are bound by our policies and procedures, and should never
be asked to contravene these by taking risks with either their PAT dogs and cats
or with themselves.
In the unlikely event that there is an incident where either one of our
volunteers or their pet is involved, they are required by Pets As Therapy to
notify Head Office. If you require a copy of the Volunteers Handbook or any
other information or have any concerns which you would like to discuss please
call Head Office on 01494 569130.
Pets As Therapy would hope that you will receive many visits from our very
special volunteers and their companion animals and that all your staff and
patients/clients will feel the proven benefits from our service.
Signed ____________________________________________________
Date _____________________________
Revised 14/01/15