Proof of Vaccination and Health Checklist

All items must be checked off below, and the form dated and signed; by checking the boxes and signing the forms, you/the owner certify all requirements. Please attach a rabies certificate or clear proof of rabies (showing vaccination expiration date) from a veterinarian.

Government and hospital regulatory organizations require increasing diligence from health care facilities regarding patient care. For therapy dog programs, this means ensuring dogs are up to date with the rabies vaccination, clean, and in good health. Some healthcare facilities may require additional dog health records or vaccinations to satisfy individual program requirements.

TDV requires new members to produce proof that their canine candidate has been properly immunized for rabies before being tested. That proof must also accompany the membership application to be kept on file with TDV. Additionally, members may be asked to send updated vaccination paperwork each year during membership renewal.

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Please check off the items below and sign/date. Attach proof of current rabies vaccination, clearly showing the date the vaccination expires.(Required)

I uploaded my dog's current rabies vaccination certificate to the TDV portal when I applied for testing. I will keep my dog's rabies vaccination current during the certification process and as a member. I will be prepared to provide rabies certificate on demand at any time during the certification process and when I am making visits as a member. Please note that a rabies tag is not acceptable documentation.

During the evaluation phase and as a TDV member, I will not take the dog on visits if he/she is not feeling well or has any symptoms of illness. I will ensure the dog is clean and free from parasites when making visits.

I certify that the dog is not on a raw meat diet.

I certify that the dog is not a hybrid, or wild canine cross (i.e., wolf hybrid, coyote hybrid, etc.).

I certify that should the dog experience any changes in behavior (fear, aggression, etc.) or health conditions (blindness, loss of hearing, pain, etc.) that I will consult TDV and, if necessary, retire the dog from therapy dog work.

Attach Rabies Vaccination Certificate(Required)

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