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Request Our Services
Use dropdown to select Type of Service Requested
Visit an Individual
Visit a Facility or Group
Presentation
Event
Individual to be visited
IndToVisitName
*
IndToVisitFirst
IndToVisitLast
About Your Group, Facility or Event...
Name of Group, Facility, or Event
Type of Audience
Elderly
Children
Teens
At-risk Teens
Special needs
Rehab Therapy (PT, OT, ST or Cognitive)
About Your Request...
Address
Please tell us where this request will be fulfilled
Street Address
Address Line 2
City
State
Zip Code
County
Type of Visit
One Time
Monthly
Specific Dates/Times
Preferred Pet Type
Dog
Cat
Miniature Equine
Other
Gender of person(s) to be seen
Male
Female
Both
Additional Details
Please include any details that will help our Volunteers better understand your needs.
Date and Time Information
Preferred Date
Time - If time sensitive, please include here
:
HH
MM
AM
PM
Contact Information...
ContactName
ContactFirstName
ContactLastName
ContactPhone
Email
* In order to process your request, please complete and submit
this form
to the office. (requests@kpets.org). Thank you!
Donor / Sponsor Opportunities
Please send me information on KPETS Donor and Sponsor Opportunities
Approvals & Legal Information
To fulfill your requests as quickly as possible, please approve the following items:
I approve KPETS to post my request on the KPETS Konnections Blog
I approve my name, email, and phone number to be posted on the KPETS Konnections Blog.
I understand that KPETS will not be held liable for the connections made.
I have signed and returned the recipient release form.