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Therapy Animal Visit Request
Would you like to have a visit from an LCM animal at your church, school, or event? Fill out this form to make your request.
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* Indicates required question
First Name
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Your answer
Last Name
*
Your answer
Mobile Number
*
Your answer
Email
*
Your answer
Home Number
Your answer
Work Number
Your answer
Street Address
*
Your answer
City
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Your answer
State
*
Your answer
ZIP Code
*
Your answer
Home Church
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Please list City & State. If you don't have a home church, simply put "None"
Your answer
One time visit or ongoing?
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One time
Ongoing
I'm not sure
Dates & Times Requested
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Your answer
Who will the therapy animals be visiting?
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Please describe the expected audience for this visit.
Your answer
Describe your event.
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Block party? Nursing home visit? Exam week?
Your answer
Facility Information
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Please list street address and contact info for the facility where the visit will take place.
Your answer
Why are you requesting a visit?
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What do you expect from us at this visit? Why do you want a therapy animal visit?
Your answer
How many people do you expect to be there?
*
Your answer
How did you hear about Living Creatures Ministry?
*
Your answer
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