Application for a consultation

Full Name:

Mailing Address:

City:

State:

Zip:

Phone:

E-mail:

1.	Which category meets your needs best:

Diabetic Alert Dog

Mobility Dog

Hearing Alert Dog

PTSD

Autism

Seizure Alert Dog

Trainer Apprenticeship

Other

Do you live in a house or an apartment?

How many people live in your residence?

Is there a fenced in yard?

Yes

5.	Do you have any other pets?	Yes	No
	(If yes, please describe:)

Are you financially able to care after a dog?

Yes

Do you have a prescription from a medical doctor for a Service Dog?

Yes

Thank you for taking the time to fill in this application. Please allow for 72hrs before calling to set up your in-person or telephone consultation. Consultations usually take around 30-60minutes, and the cost is $65.

To Schedule Your Consultation Call:
208-386-DOGS (3647)