Facility Support Dog Guide Expression of Interest - Lions Foundation of Canada Dog Guides

Organization's name *

Province or territory of the organization *

Your name & position within the organization *

Contact email *

Contact phone *

Does your organization serve individuals that have experienced trauma due to criminal behaviour? *

Yes
No

Demographic served by the organization (i.e. client, adult, seniors) *

How long has the organization been in service? *

Does the plan to introduce a FSD have the support of senior management within your organization? *

If the organization is accepted into the program, a staff member will need to be appointed the primary handler (caregiver) of the Dog Guide to support its work for the organization. This includes taking the Dog Guide home at night to care for it. Has a Primary Handler been identified within the organization? *

Will the FSD be supporting work primarily conducted in-person, or virtually? (IE - over video conference) *

Is your organization prepared to take on the financial responsibility of a FSD? Annual costs could amount to $1,500 - $10,000. *

Yes
No