Canines for Vets – 2619 East State Street, Hermitage, PA 16148 – 724-346-3818
Registration to Participate in
Canines for Vets Training Program
Rescue Name
Address
Phone
Email
Website
How long in operation?
501(c)3?
Contact Name
Phone Number
Second Contact Number
Are your dogs kept up to date on vaccines?
If so, please indicate which ones
DHLPP or DHPP ___ Yes ___ No
Administered by your facility?___ By a licensed vet? ____
Rabies ____ Yes ____No
Bordatella (kennel cough): ____Yes
____No
If yes: Administered by your facility?____ By a licensed veterinarian?____
Do you have proof of vaccines? ____Yes
____No
Are your dogs tested for Heartworm? ____Yes
Given monthly preventative? ____Yes
____No
____No
Given monthly flea treatment product? ____Yes
____No
Please indicate where your dogs reside:
In kennel _____
Foster homes_____
Your home_____
We are excited to have you as part of our program. Rescues that are registered with us may have dogs
selected that meet our criteria to enter our program to be trained as “comfort” dogs (or “ESA” dogs) for
local veterans. These dogs will have all medical and living expenses paid for the lifetime of the dog. If
your dog is selected, the rescue agrees to relinquish ownership to Canines for Vets and provide all
known history and any medical information. In addition, the rescue accepts that all adoption screening
and selection will done at the discretion of Canines for Vets. The rescue understands that any known
behavior issues that are not disclosed to Canines for Vets may disqualify the rescue from Canines for
Vets permanently.
Please sign: _____________________________
Print Name: ______________________________
Title: ________________________________
Date: _______________
Please email to jenny@thelearningdog.com or mail to
The Learning Dog
Attn: Jenny Falvey
757 N. Main St.
Hubbard, OH 44425