Animal-Assisted Therapy Emergency Contact Form
About this free form template

Ensure Safety and Preparedness for Your Animal-Assisted Therapy Programs

Animal-assisted therapy (AAT) is a powerful therapeutic approach that brings comfort, healing, and emotional support to patients through interactions with trained therapy animals. Whether you're running a healthcare facility, mental health practice, rehabilitation center, or educational program, having comprehensive emergency contact information is essential for participant safety.

This Animal-Assisted Therapy Emergency Contact Form template helps you collect critical information before therapy sessions begin, including emergency contacts, allergies to animals, past experiences with pets, fear or anxiety around animals, and acknowledgment of proper animal handling procedures.

Why This Form is Essential for Therapy Providers

When working with both vulnerable populations and therapy animals, preparation is everything. This form helps you:

  • Capture multiple emergency contacts with phone numbers and relationships to participants
  • Document animal allergies and sensitivities that could cause medical emergencies during sessions
  • Identify fear or anxiety around animals to appropriately match participants with therapy animals
  • Record past pet ownership and comfort levels to personalize the therapeutic experience
  • Ensure participants understand handling rules for the safety of both humans and animals
  • Meet liability and consent requirements for animal-assisted interventions

Perfect for Healthcare and Therapy Professionals

This template is designed specifically for:

  • Mental health counselors and therapists incorporating animal-assisted interventions
  • Healthcare facilities offering pet therapy programs for patients
  • Rehabilitation centers using therapy animals for physical or occupational therapy
  • Senior care facilities bringing in therapy animals for residents
  • Schools and special education programs with therapy animal visits
  • Veterans' programs using service and therapy animals for PTSD treatment
  • Hospitals and hospice care providing comfort through animal visits

What Makes This Form Comprehensive

Unlike generic emergency contact forms, this template addresses the unique considerations of animal-assisted therapy:

  • Medical Safety: Captures allergies to pet dander, fur, saliva, and other animal-related allergens
  • Psychological Safety: Identifies fears, phobias, or trauma related to animals
  • Experience Assessment: Records previous pet ownership and comfort handling animals
  • Clear Protocols: Ensures participants understand and agree to therapy animal handling rules
  • Emergency Preparedness: Collects multiple contacts and medical information for quick response

Streamline Your Intake with Paperform

With Paperform's intuitive form builder, you can customize this template to match your practice's branding and specific requirements. Add your logo, adjust colors to match your calming therapeutic environment, and embed the form directly on your website for seamless client onboarding.

Conditional logic lets you show follow-up questions based on responses—for example, if someone indicates they have animal allergies, you can ask about severity and previous reactions. If they express fear of dogs, you can route them to cat-assisted or other therapy options.

Automate Your Therapy Program Workflow

Connect this form to your broader practice management system using Stepper (stepper.io), Paperform's AI-native workflow automation tool. When a new participant submits their emergency contact form, you can:

  • Automatically send their information to your EMR or practice management software
  • Trigger email confirmations with pre-session instructions and facility location
  • Alert therapy coordinators when someone indicates allergies or fears that need accommodation
  • Create participant profiles in your CRM with all relevant safety information
  • Schedule follow-up reminders to update emergency contact information annually

Ensure HIPAA-Adjacent Best Practices

While Paperform is not HIPAA compliant, this form template helps you maintain professional standards for protecting sensitive participant information. You can enable SSL encryption, control data access with role-based permissions, and export data securely to your HIPAA-compliant systems.

For mental health professionals, social workers, and healthcare providers, having organized, accessible emergency contact information is not just a best practice—it's a fundamental part of providing safe, ethical care.

Trusted by Therapy Professionals Nationwide

Healthcare providers, mental health practitioners, and therapy animal handlers trust Paperform to manage their client intake and emergency contact collection. With SOC 2 Type II certification and robust security features, you can feel confident that sensitive participant information is protected.

Whether you're a solo practitioner just starting to incorporate animal-assisted interventions or a large facility with an established therapy animal program, this form template gives you a professional, comprehensive tool to ensure every participant's safety and comfort.

Start using this Animal-Assisted Therapy Emergency Contact Form today and create a safer, more prepared environment for both your participants and your therapy animals.

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