Glengary Therapy Dog-Allergies and/or Fears

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This survey is for INCOMING KINDERGARTEN & NEW FAMILIES to share information if their student(s) have a fear of dogs and/or severe allergies to dogs. RosaLeigh Johnson and/or Laura Locke will be in contact so that we can collaborate and develop a proactive plan to meet your child’s needs. If you have any questions, please contact lauralocke@wlcsd.org or rosaleighjohnson@wlcsd.org.

Email *

Parent/Guardian First & Last Name *

Parent/Guardian Phone Number *

(Child 1) Student First & Last Name *

Grade *

Kindergarten

First

Second

Third

Fourth

Fifth

Row 1

Please describe your student's severe allergy to dogs.

Do you have documentation from your pediatrician?

Yes

Clear selection

Please describe your student's fear of dogs.

Submit

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