Service Dog Candidate Form

Address *

Line 1

Line 2

City

State

Zip Code

Country

Other Household Members - Names and Ages (Humans and Animals - for animals, list type of animal as well) *

Do you have a dog or do you need help finding a dog? *

I have a dog that I would like to use as my service dog I have a dog but am not sure if they will be right for the job I do not have a dog yet and need help finding the right one I do not have a dog yet but have found an option

How do you imagine the dog helping you? (If you don't have specific tasks in mind, I can help you determine that later.) *

If you chose "other," or would like to elaborate on any of the chosen locations above, please put that here. *

Are there any accommodations you would need for training sessions? *

If you have a dog already, please fill out the next section on information about your dog. If you don't, you can skip ahead and hit submit!

What is your dog already good at? What are some of their favorite things? *

Please list anything your dog barks at, growls at, is afraid of, etc. here. *

Does your dog have any ongoing health issues? (Please describe if so.) *

Any other information you think is important for me to know about your dog can go here! *

Please fill out the form below - I will contact you shortly to get started!

Note: I have had issues with the form confirming submission recently and am working with the website host to resolve. Please feel free to email me at [email protected] to confirm I've received your form!