Service Dog Interest Form

Fill out the form below to indicate that you have an interest in training a service dog.

    What is your preferred contact method?

    Do you meet the ADA definition of disabled? "...one must have a disability, which is defined by the ADA as a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment." See https://www.ada.gov/ada_intro.htm to read more

    What kind of tasks or work do you want a dog to perform to assist you, that directly mitigate your disability? What would you like a dog to do?

    Which of the following best describes you?