Therapy Team Volunteer Application for Animals

Thank you for your interest in volunteering at UCHealth at University of Colorado Hospital with your Therapy Animal. Therapy Dogs and their handlers play an important and meaningful role in providing service to patients and their loved ones. We hope you find your experience here to be valuable and worthwhile.

New Volunteer Sign up Process. Please complete two applications: one for Therapy Animal AND one for Handler

Step One: Complete the online application below.

Step Two:

Upload the following three forms:

Therapy Dog Certification from either Therapy Dogs International, Denver Pet Partners, or Alliance of Therapy Dogs.
Rabies Shot Information.
Current Health Certificate with vaccination list from your veterinarian.

Step Three: Complete Handler application (see separate online application under Therapy Animals).

Step Four: Send an email to uchvolunteerservices@uchealth.org to request an interview with you and your therapy animal.

Step Five:

Complete 2-3 shadow visits with an experienced Therapy Animal team as part of your training.

We look forward to meeting you and welcoming you to our team of volunteers making a difference at UCHealth. If you have any questions, please feel free to call our office at 720.848.1886.

Volunteer Services Department
Jenny Ricklefs, Manager, 720.848.4068, Jennifer.Ricklefs@uchealth.org
Melissa Strickland, Volunteer Coordinator. 720.848.4070, Melissa.Strickland@uchealth.org
12605 East 16th Ave, Mail Stop F771, Aurora CO 80045

Required fields are noted in red.

User ID

User ID (verify)

Password

Password (verify)

You can enter the User ID (email address) field above as an extension of your email to allow for a separate login to the Therapy Animal's record, but any emails we send will automatically fall under your email.

For Example: If your email is JaneVolunteer@gmail.com you can create the login for the animal as JaneVolunteer+Dog@gmail.com adding "+Dog" before the @ symbol.

CONTACT INFORMATION

* Animal/Dog's name

* Last Name

Gender

* Animal/Dog's DOB

* Handler's E-mail:

* Handler's Cell Phone

Please upload a photo of the animal/dog, make sure it is loaded upright.

EMERGENCY CONTACT

Please provide the name and number of someone we may contact in case of an emergency.

* Name:

* Phone:

* Relationship

Therapy Dog Certifying Organization

Animal

* Please upload Therapy Animal Certifying Organization Certificate:

* Expiration date

* Please upload Rabies Vaccination:

Rabies Status

* Rabies Last Result Date

* Please upload Veterinarians Health Certification and Vaccination List:

Additional page for Veterinarian's Health Certification and Vaccination List (if needed):

I agree that I will not feed my Therapy Animal a raw diet at any time when volunteering with UCHealth- Metro Denver due to potential infection risks to humans.

I verify that the information provided is accurate to the best of my knowledge. I authorize UCHealth - Metro Denver and its agents to confirm all information provided on the application.

* Therapy Animal Handler - please type your name in this field as a form of electronic signature

* Date: