In Case Of An Incident or Accident

  • Immediately remover the dog from the area.

 

  • Get help for the person who has been injured.

  • Notify the facility about the incident.

  • Immediately notify the accident or incident to Dog With A Purpose, in writing.

You must immediately report any type of incident that may occur to Dogs With A Purpose, for the insurance provider to cover it.  Any delay of a few days or more may mean that you have not provided "notification in a timely manner", the insurance provider may then seek to disclaim coverage.

Full Name of Therapy Dog Handler:

       

        _____________________________________________________

Name of Therapy Dog:                                                                               ID#:

        _____________________________________________________                  ________________________

Facility's Name: _____________________________________________________________________________

              

Address: _______________________________________________________________________________

             

        Contact Number: ______________________________________

 

        Date incident:__________________       Time: ______________

Name of person or people involved in the incident:

Name:                                                                                                   Contact Number:

           

______________________________________________________                  _________________________

______________________________________________________                  _________________________

Names and Phone numbers of people present when the incident occurred:

         Name;                                                                                                   Contact Number:  

             __________________________________________________________                         _____________________________

              __________________________________________________________                        _____________________________

              __________________________________________________________                        _____________________________

              __________________________________________________________                        _____________________________

Detailed written version of the incident:

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

 

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________