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Buy A Service Dog – Contact Us
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Service Dog Application
SERVICE DOG APPLICATION
Please enable JavaScript in your browser to complete this form.
APPLICANT - PERSON FILLING OUT FORM (Must be at least 21 years old)
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First
Last
NAME OF YOUR CHILD, SPOUSE or PARENT
APPLICANT AGE (The person needing a service dog)
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THE PARENT or PERSON answering the questions and submitting this application:
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I'm an ADULT OVER 21, applying for myself
I'm an ADULT OVER 21, applying for my child, spouse or parent
I am younger than 21 years old
STOP!!! DO NOT SUBMIT THIS APPLICATION YOURSELF. Your parents, attorney or legal guardian must submit the application for you from their email address. We will not talk to you, unless we talk to your parents or legal guardian first. It does not matter your age, even if you are over 21. IF SOMEONE ELSE IS PAYING OR HELPING YOU PAY, they must apply for you. ANY DISHONESY OR LYING ABOUT YOUR AGE, and you will be banned for life.
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City
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State
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Email
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Telephone
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1. MEDICAL DIAGNOSIS (Click all that apply)
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PTSD
Autism
Depression
Traumatic Brain Injury
Anxiety Disorder
Other (Specify in the comments section below)
2. IMPAIRMENTS (Click all that apply)
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I am really depressed
Leaving the house is increasingly difficult
I sometimes wish I was dead
My depression is incredibly painful
I have addictive behaviors
I'm so depressed
I suffer from chronic pain
I am not happy with my life
I am lonely
I stay up really late a lot
My panic anxiety is off-the-hook
I have terrifying nightmares
I can't turn my thoughts off
I need meaning in my life
I have trouble connecting with others
I love animals and they make me feel better
Other - Include in comments below
3. FULLY-TRAINED ADA SERVICE DOGS - Avl. 2022
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Min. Australian Shepherds, $36,000, Avl. August, "The smartest dog in the world"
AKC Golden Retrievers, $38,000 - Avl. this Fall- Reserve Now
4. I have a SMALL DEPOSIT now to reserve my service dog.
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Yes
No
STOP!!! PLEASE DO NOT SUBMIT THIS APPLICATION. Our website www.Superdog.com has information about the laws and what service dogs do for people, etc. THIS APPLICATION IS FOR PEOPLE LOOKING TO BUY OR RESERVE A SERVICE DOG NOW. We are not a charity, the government, or a social agency. MEDICAL INSURANCE will not buy you or your child a service dog. We are here to help people get a service dog. WE SELL FULLY-TRAINED SERVICE DOGS, not convince people they need one. Please bookmark our website for when you are ready to buy. CAN'T AFFORD A SERVICE DOG? NEED A CHARITY? Go to Google and search for "Service Dog Charities."
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5. WHEN do you want to buy or reserve your service dog?
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If I qualify and one becomes available
I am not ready to buy or reserve a service dog
STOP!!! PLEASE DO NOT SUBMIT THIS APPLICATION. Our website www.Superdog.com has information about the laws and what service dogs do for people, etc. THIS APPLICATION IS FOR PEOPLE LOOKING TO BUY OR RESERVE A SERVICE DOG NOW. We are not a charity, the government, or a social agency. MEDICAL INSURANCE will not buy you or your child a service dog. We are here to help people get a service dog. WE SELL FULLY-TRAINED SERVICE DOGS, not convince people they need one. Please bookmark our website for when you are ready to buy. CAN'T AFFORD A SERVICE DOG? NEED A CHARITY? Go to Google and search for "Service Dog Charities."
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6. MORE INFORMATION ABOUT YOURSELF. (This answer determines who gets chosen.)
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7. WHAT IS THE BEST PHONE # AND TIME to call you if we have more questions, or want to talk to you because your application was accepted?
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Submit Application