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Service Dog Application
SERVICE DOG APPLICATION
Please enable JavaScript in your browser to complete this form.
PERSON FILLING OUT THIS APPLICATION:
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First
Last
1. THE PERSON ANSWERING THE QUESTIONS:
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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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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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2. Did a MEDICAL DOCTOR or THERAPIST recommend an ADA-COMPLIANT SERVICE DOG? (Not an Emotional Support Animal)
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Yes (Not required)
No
2B CLICK ALL THAT APPLY TO APPLICANT:
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I have a mental or physical disability
I do not have a mental or physical disability
Somebody has money and just wants the best dog and trainer
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
Sleep Disorder
Medical Disability
Other (Specify in the comments section below)
4. TASKS YOUR DOG WILL BE TRAINED TO HELP WITH. (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)
5. BRIEFLY, Your Story. Who are you, what do you do, what happened, etc?
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6. How will getting a service dog make you, your spouse, or your child, a MORE PRODUCTIVE and HAPPIER PERSON?
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APPLICANT - Person who needs a service dog or parent applying for them.
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First
Last
(IF APPLICABLE) NAME OF CHILD OR SPOUSE who needs a service dog:
APPLICANT'S AGE (Age of the person who needs a service dog)
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Email
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State
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City
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Telephone
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7. ADA PSYCHIATRIC & MEDICAL SERVICE DOGS, TOTAL COST: $50,000
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I can afford to buy a fully-trained service dog
I CANNOT AFFORD TO PAY $50,000, and fly out to California 2 or 3 times
7B. HOW WILL YOU PAY?
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I have my own money
MY PARENTS or somebody else is paying
7C. DO YOU HAVE $50,000 TO PAY FOR A SERVICE DOG if we have one available for you now? (Click all that apply)
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Yes, I already have the money in a bank or retirement account
Yes, but I want to get my service dog in 12 to 24 months
Yes, but I have a Court executor or bank fiduciary
Yes, but someone else besides me pays my bills or writes the checks
Yes, but I/we need to sit down and look at our finances
No, I only have a portion of the money now
I will have it 12 to 24 months
I will be paying part of the cost with credit cards
I can take out a loan or borrow money
IN DOLLARS, How much money do you have saved now to buy a service dog?
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IN DOLLARS, How much money would you need to borrow or put on a credit card to buy a $50,000 service dog?
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APPLICATION DENIED - People with money don't say "We need to sit down and look at our finances." Only somebody with no money would say that. This is a business. Feel free to contact us when you have $50,000 to pay us, or you are just wasting everyone's time.
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7D. HOW COMFORTABLE ARE YOU PAYING $50,000 for a service dog, or paying that much for a service dog trainer to commit to a year or longer to train a dog for you?
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I or we have money so it is no big deal spending $50,000
Honestly, it will be a little stretch for me or us
I or we can't really afford it, but we are desperate to get help
7E. HAVING MONEY SOMETIMES IS NOT ENOUGH. Did you go to our Facebook page and see the dogs for sale like you were instructed to demonstrate to us that you can follow instructions and are serious.
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Yes, I did. That is why I'm excited to have found you.
No, but I promise I will later
No, I don't do social media or not able to
UNFORTUNATELY, unless you are able to ask a friend or relative to help you out by letting you use their Facebook account to look at the 1000's of photos and 100's of videos of dogs we have trained posted there, your application will be denied. PLEASE PROVIDE US THREE NAMES of dogs you saw on our Facebook page in the box below to prove you saw the page. URL: www.facebook.com/davethedogtrainer
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For free and low-cost service dogs, Google "service dog charities."
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STOP!!! DO NOT SUBMIT THIS APPLICATION YOURSELF. Your parents or whoever is paying must submit an application for you.
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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.
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THIS APPLICATION WILL BE DELETED and NO ONE WILL READ IT. Your parents or whoever is paying must apply for you.
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MEDICAL INSURANCE, Social Security, the VA, and Make-A-Wish DO NOT buy service dogs.
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Don't worry. You found the best one. We will call you within 48 hours.
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Please contact me about buying my service dog.
Submit Application