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Service Dog Application
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SERVICE DOG APPLICATION
Please enable JavaScript in your browser to complete this form.
YOUR NAME:
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First
Last
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. FULLY-TRAINED off-leash obedient ADA-COMPLIANT (PSYCHIATRIC) MEDICAL SERVICE DOGS. Be safe. Take your dog to work, school, on vacations and airplanes. LAY-AWAY PAYMENT PLANS AVAILABLE. Call us after you submit this application. LIMITED AVAILABILITY. To get a dog in 2024, you need to reserve one now before they are all sold.
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GOLDEN RETRIEVER with year of training, $45,000
I cannot afford $45,000
THIS IS A BUSINESS. WE RECOMMEND YOU READ THE FOLLOWING SENTENCE: 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.
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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.
HOW WILL YOU PAY for your service dog?
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MY OWN FUNDS with zero of my parent's money
Someone else is helping me pay
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 $45,000 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 $45,000 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. 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
4. 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)
APPLICANT - PERSON FILLING OUT FORM (Must be at least 18 years old)
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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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5. Your Story. Who are you, what do you do, what happened, etc?
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6. Other Information (optional)
IMPORTANT!!! YOU NEED TO CALL OR TEXT US at (916)701-6458 AFTER YOU PRESS SUBMIT. We have trained dogs for sale and available to reserve now. We will answer all your questions.
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I will call or text the office as instructed
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.
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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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Submit Application