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Buyer Application
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SERVICE DOG APPLICATION
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YOUR NAME:
*
First
Last
THIS APPLICATION IS MOSTLY FOR AFTER-HOURS or if you cannot talk right now. PLEASE CALL US AT (916)701-6458 if you have money to pay and looking to buy a service animal. People who call get priority and get moved to the front of the line.
I will also call when I am available during regular business hours.
1. THE PERSON filling out this form:
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I'm an ADULT OVER 18, applying for myself
I'm an ADULT OVER 21, applying for my child, spouse or parent
I am younger than 18 years old
STOP!!! DO NOT SUBMIT THIS APPLICATION YOURSELF. Your parents, conservator, attorney or legal guardian must submit the application for you from THEIR EMAIL ADDRESS. We cannot talk to you if you are UNDER 18 YEARS OLD. If you LIE ABOUT YOUR AGE or IMPERSONATE YOUR PARENT, you will NEVER get a service dog and be banned from ever re-applying.
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STOP!!! DO NOT SUBMIT THIS APPLICATION.
PLEASE. DO NOT SUBMIT THIS APPLICATION. It will just go in the trash and be deleted, and you will make people mad at you for not following instructions and wasting our time.
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SUBMITTING THIS APPLICATION WILL JUST GET YOU BLOCKED. No one will read your application, your email and telephone number will be blocked, and you will be permanently banned from getting a service dog for not following directions. THIS IS A DISABLED-OWNED BUSINESS. DO NOT SUBMIT THIS APPLICATION and WASTE OUR TIME.
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2. PSYCHIATRIC & MEDICAL SERVICE DOGS. We sell dogs that help disabled people live more productive lives and be happier people. ONE YEAR OR LESS WAIT.
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ADA Golden Retrievers, $60,000
I CANNOT afford to pay
How will you pay for a service dog?
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With My Own Money
SOMEONE ELSE is helping me pay
THIS IS A BUSINESS. WE RECOMMEND YOU READ THE FOLLOWING SENTENCE THOUGH: For free and low-cost service dogs, Google "service dog charities."
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STOP!!! DO NOT SUBMIT THIS APPLICATION.
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DO NOT SUBMIT THIS APPLICATION. Please, you need to Google "service dog charities" to get the help you need. Charities help people with little or no money. We are disabled ourselves and train dogs so we don't have to go on welfare and sponge off the rest of society. Please respect that.
*
SUBMITTING THIS APPLICATION WILL JUST GET YOU BLOCKED. No one will read your application, your email and telephone number will be blocked, and you will be permanently banned from getting a service dog for not following directions. THIS IS A DISABLED-OWNED BUSINESS. DO NOT SUBMIT THIS APPLICATION and WASTE OUR TIME.
ARE YOUR PARENTS or SOMEBODY ELSE helping you pay?
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PART or ALL OF THE COST is being paid by somebody else
WHO IS PAYING THE $60,000 COST? Medical Insurance, SSA, the VA, and Make-A-Wish do not buy service dogs.
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THE PERSON'S NAME who is paying?
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THEY SPECIFICALLY TOLD YOU they will spend $60,000 to to buy you a service dog?
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Yes
No
STOP!!! DO NOT SUBMIT THIS APPLICATION. You need to TALK TO THE PERSON FIRST and get their permission.
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WHAT IS THEIR RELATIONSHIP TO YOU?
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TELEPHONE NUMBER of the person paying?
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3. WHEN DO YOU WANT YOUR SERVICE DOG?
As Soon As Possible
In 2025
I don't know
5. TASKS YOUR DOG WILL BE TRAINED FOR. (Click all that apply)
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Public Access
Reduce Medications
Go to work or school with you
Alternative to drugs
Alert to mental or medical distress
Interrupt Behaviors
Deep Pressure Therapy
Help you sleep
Fear of leaving home
Help with social interaction
Panic or Social Anxiety
Help with mobility
Stop suicidal ideation
Bring joy into your life
Make you more productive
Give your life meaning
To stay in school or keep working
Other (Explain in comments below)
4. MEDICAL DIAGNOSIS (Click all that apply). If the applicant is TOO SICK, too depressed, too anxious, too unpredictable, unstable, or detached from reality, etcetera, getting a service dog would not be in anyone's best interest.
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PTSD
Traumatic Brain Injury
Depression
Narcolepsy
Anxiety Disorder
Borderline Personality Disorder (BPD)
Autism
Other (Specify in the comments section below)
Medical Disability
APPLICANT - PERSON FILLING OUT FORM (Must be at least 18 years old)
*
First
Last
NAME OF CHILD OR SPOUSE who needs a service dog:
Email
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APPLICANT'S AGE (Age of the person who needs a service dog)
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State
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City
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Telephone
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6. Your Story. Who are you, what do you do, what happened, etc?
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Other Information (optional)
DO NOT SUBMIT THIS APPLICATION. Please, you need to Google "service dog charities." Charities help people with little or no money. We are disabled and train dogs so we don't have to go on welfare and sponge off the rest of society. Please respect that.
*
DO NOT SUBMIT THIS APPLICATION!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Unless you want people mad at you, and want to be permanently banned from getting a service dog from our organization.
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WE HAVE DOGS AVAILABLE NOW!!! Don't worry. You found the best one. We will answer all your questions and give you great service.
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Please contact me about buying a service dog.
Submit Application