Retrieving Independence

Facility Dog Application

Company Name

* First Name

* Last Name

* Email

* Phone

* Address

* City

* State

* Postal Code

We are excited that you are considering a facility dog and have come to Retrieving Independence. Included is all the information you will need to gather and submit to begin the evaluation process.

The total investment of a RI service dog is $30,000. Through generous donations we are able to offer our dogs below that cost. Service dogs that are found to be appropriate for facility dog placements are typically $5000 for non-profits and $9500 for profits (for dogs placed in 2022).

When we receive your completed application package, the first step of the application process will be complete.

The second step is an interview, either in person or over the phone. The interview is crucial in helping us understand your facility needs, which will greatly assist us in matching you with a dog. The last step is the hardest, waiting for your dog. Your wait can be anywhere from 6 months to 2 years, or longer, depending on your needs and our current waitlist.

Please confirm that you understand:

I understand that the handlers of the facility dog will be required to attend a training camp in Nashville Tennessee.

I agree to a minimum of 12 monthly check-ins with RI staff for the first year of placement.

I understand that RI retains ownership of the facility dog for its working life and can remove the dog if the care and conditions do not meet our standards.

I understand that if I am unable to care for the facility dog or no longer need a facility dog, RI will be notified and given first right of refusal to ownership of the dog.

I understand that an RI facility dog is never to be sold or placed in another home/facility.

* What is your primary need for a facility dog?

* Please describe your facility - number of staff, clients served, environment, etc.

* How would you describe the temperament of the patients/clients you serve?

* What are the anticipated daily working hours for the facility dog? Is there a designated place for rest?

* Who are you recommending as primary handler and secondary handler of the facility dog? Please describe each home environment.

* Does your facility use any special equipment, such as wheelchairs, walkers, etc.?

* Will the facility dog be exposed to cigarette smoke at the facility or in the handler's home?

* What goals does your facility have for its facility dog?

* Please list all animals currently living with the proposed primary and secondary handlers and their individual ages and temperaments.

* Please explain the proposed handler's primary mode of transportation.

* Will the handler be able to attend a training camp in the Nashville, TN area?

* Will RI staff be able to observe the handler at the facility with the dog during the training camp?

Any other information you'd like to share with the RI team (optional):

Thank you!

Facility Dog Application

Please make sure your application is complete before submitting. Incomplete applications cannot be considered.

To complete your application please email the following to jen@riservicedogs.org

Application Signature Page (attached below)

Once this documents are submitted please pay the $200 application fee to finalize your application:

Application Fees can be paid online here or by check . Checks should be to be made out to Retrieving Independence Inc. and mailed to

Attn: Retrieving Independence

2400 Clifton Avenue

Nashville, TN 37209

Please reach out to us if you have any questions and we look forward to reviewing your application!

Retrieving Independence

Facility Dog Application

We are excited that you are considering a facility dog and have come to Retrieving Independence. Included is all the information you will need to gather and submit to begin the evaluation process.

The total investment of a RI service dog is $30,000. Through generous donations we are able to offer our dogs below that cost. Service dogs that are found to be appropriate for facility dog placements are typically $5000 for non-profits and $9500 for profits (for dogs placed in 2022).

When we receive your completed application package, the first step of the application process will be complete.

Please confirm that you understand:

Thank you!

Facility Dog Application

To complete your application please email the following to jen@riservicedogs.org

Downloads

Facility Dog Applicant Signature Page