Event Submission Form
MGH Charlestown Healthcare Center
Form Submission Date
3/16/23, 4:00 AM
Requested Event Date
Ok
Administrative only Feedback
MGH main has said no "cant send "our" teams" to satellite facilities. hm.
Obtained All Approvals?
Do You Need Insurance Rider?
Pets & People Photo Policy
Read Event Planning Guide?
Corporate
Booked P&P in last 2years?
No
How'd you learn about P&P?
Name of School, College or Corporation
MGH Charlestown Healthcare Center
Street/Building
73 High St
City or Town
Charlestown, MA 02129
Website
Requested Date of Event
Ok
What time is your event?
June 7th 2:30 2nd floor conference room
Why do you wish for Pet Therapy at your Event?
Destress staff and for enjoyment
Location(s) on premises reserved in advance?
Yes Indoor
Event space indoors or outdoors?
Please provide a description the reserved location of event.
2nd floor conference room
Please describe Alternate Location if any
What is the expected attendance?
Dogs/Cats or both?
Dogs Only
Minimum # teams requested
1
Maximum # teams requested
1
Have you considered how to promote this event?
Link or Map of your Campus
Parking Arrangements
Parking available on premises
Will other Pet Organizations be present?
No
Outline any protocols needed for volunteers to come to your facility.
Masks mandatory
Additional Details/Comments/Questions
Question about insurance
Contact Information
Day of Event Contact Info
Name
Ok
Cell Phone
JobTitle
Alternate Day of Event Contact Info
Name
Cell Phone
JobTitle
Event Requester Contact Info
Name
Elizabeth DellaPorta
Phone
617-515-0221
JobTitle
Wellness Committee Chairperson