Service Dog Application
The Precision Team will review your application and contact you about the next steps within ten business days of receiving your application. Precision Service Dogs values your privacy and anything shared with us will be kept confidential. We will never discriminate on the basis of gender, sexual identity, race, ethnicity, or anything else. If you have any questions or concerns, please reach out to Info@PrecisionCanine.Org.
First Name
Last Name
Do you have a preferred name? Please also put a pronunciation if applicable.
Pronouns
Email
Phone Number
Date of birth
How did you hear about us?
Friends
Social Media
Other
Website
Address (Street, City, State, Zip Code, Country)
Please describe your home environment. Do you rent or own your home? Are you in an apartment or house? Do you live in the suburbs, a city, or a rural area? Do you have a fenced in backyard?
Please list all members of your household including their age. If you live alone, please indicate this.
Is someone else available to assist with the dog if primary handler needs help/assistance with care of the service dog?
Have you discussed getting a service dog with a licensed medical professional?
Yes
No
Do you have any coat-concerns for a dog? Most of our dogs are labrador retrievers, but golden retrievers and standard poodles may be available to meet specific handlers needs.
Do you currently have a prospect, puppy, reservation with a breeder, or other engagement with a dog for service dog work?
Do you currently use a service dog? Age of dog?
If you currently have a service dog, what tasks does he or she perform for you?
Do you currently use mobility aids or other assistance equipment?
The ADA requires that all service dog handlers are disabled. Do you have a disability? How does this affect your daily life? You may list your diagnoses if you feel comfortable doing so.
Are you able to travel, or will training and placement work travel to you?
Are you planning to owner-train or purchase fully trained? Please list preferences:
What service dog tasks would be helpful for you?
Do you currently own any pets? Please list name, species, breed, and age if applicable.
Do any of your pets exhibit concerning behaviors (excessive vocalization, aggression, etc)? Are you willing to re-home the pet if it poses a risk to a service animal?
What is the level of training of any dogs in your household (if applicable)?
What brand of food do you feed your current dogs (if applicable)?
Are the dogs in your household a healthy weight (if applicable)?
Do your dogs receive regular vaccinations, exams, dental care, heart worm prevention, etc (if applicable)?
What is the veterinary practice you currently use (if applicable)?
Are you in the United States Armed Forces?
Yes
No
Is there anything else you would like us to know?
Please upload a photograph of your drivers license or government issued identification to verify your identity.
Select a File
Your Signature
Clear
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