Post-Placement Monthly Report: Facility Dog Consider the most recent month when completing this report.Name* First Last Dog's Name* Email* Please describe how your dog is acclimating to your facility and the population you serve.*Please describe how your dog is acclimating to your home environment.*Please describe a typical day at work with your facility dog this month.*Is your dog performing the correct behavior at least 90% of the time when cued for all Foundation Cues and Assistive Tasks?*Do you have cues you need help with?* Yes No If yes, please explain which cues.*Does your dog demonstrate any stress, adverse body language, or avoidance when:* Being dressed or groomed Traveling (entering and exiting buildings, riding in car, plane, train, etc.) Being in crowded or high distraction environments Being around other dogs or animals Being around children Other None of the above If Other, please explain.*Are there any changes in your life or in your family dynamics that could affect your dog (such as employment status, number of members in household, health, education, etc.)?* Yes No If yes, please explain.*Have there been any incidents that you feel should be reported to TLCAD? See your Client Handbook for examples of incidents that should be reported.* Yes No If yes, please explain.*Does your dog have any medical or health problems that you are concerned about?* Yes No If yes, please explain.*Any other comments, questions, or concerns about your dog and/or situations or events pertaining to your dog:Please share an example from this month about how your dog has benefited the population you serve.*Please list how many individuals your facility dog has interacted with and/or supported in the last month in each category: Clients*Please list how many individuals your facility dog has interacted with and/or supported in the last month in each category: Staff*Please list how many individuals your facility dog has interacted with and/or supported in the last month in each category: Other*In the past month, what was the average amount of time per day that your dog spent supporting the population you work with?*
