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Changing one Life at a Time: Service Dogs for American Heroes and Veterans

At Dogs4Service, we specialize in providing trained service dogs to veterans and American heroes, helping to enhance their quality of life and independence.

Our highly trained service dogs are equipped to perform a variety of tasks that assist individuals with disabilities.

We are dedicated to improving the quality of life for those who have dedicated their lives to serving our communities and country.

Name*

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E-mail*

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Full Address*

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Phone*

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Employer Information

If employed, will your work allow you to bring a Service Dog to work once trained?

College, If currently Attending please provide full school details including, credit hours taking, school address, and if your staying on campus

Have you been convicted of a crime - If yes, please explain what crime the conviction was for*

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Emergency Contact Name, Address, Phone Number, Relation to Applicant*

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Have you owned a dog before?*

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if Yes, how long did you own each dog, what breed(s) and why do you no longer have? (passed away, given away, etc)

Have you ever needed to Re-home an animal? if so Why?

Military Status - Active, reserve, inactive, retired, Medically separated, separated, discharged*

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Enlistment date - Dischage date

Service Connected Disability - TBI, PTSD, Military Sexual trauma, Anxiety Disorder, Physical Disability, Medical Disability, Other*

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Branch of Service - Air force, Army, Coast Guard, Marine Corps, Navy, Air National guard, Reserves*

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How many active combat deployments have you had, if Any?*

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Who is in your Household - Live alone, caregiver, parents, Significant other, Spouse and kids, etc*

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If kids in the home, what ages? this helps with placing the right dog with you

Do you have a fenced yard?*

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If you don't have a fenced yard, what plans do you have to exercise a dog?

Annual Household income*

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Do you have the financial means or support to cover the annual costs ($2,000-$3,000) of veterinarian care including monthly flea and tick treatment, heartworm preventative, food and supplies?*

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Do you have the financial means to travel to Plainwell, MI at least once a week for training? If not more.*

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Do you understand this is a lifelong commitment to the dog?*

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Are you committed to fully participate and the learning process of having a service dog?*

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Are there any other pets in the household (even including other than cats and dogs hamsters, snakes, fish, etc)?

What are the Age(s)/Sex/Breeds of other animals in the house? are they Spayed/Neutered?*

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What are their Personalities (Aggressive, Neutral, Submissive)?

If unable to supervise or be with the dog , who will you have taking care of them during this time? *

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Reference #1 Name, Address, Phone, Email and relation to Applicant*

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Reference #2 Name, Address, Phone, Email and relation to Applicant*

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Reference #3 Name, Address, Phone, Email and relation to Applicant*

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Reference #4 Name, Address, Phone, Email and relation to Applicant*

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Do you currently have a veterinarian? If so, Please list there name, address, phone, email and clinic name as well as how many pets you currently take there*

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If you don't Currently have a Veterinarian who do you plan to use and why?

Home - Do you Own, Rent, Lease, Land Contract, Live with someone else? If Renting, please provide landlords name, email, address, phone as well as Does your lease allow for pets?*

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Define your need for a service dog (please be as specific as you can) and what you will gain from them? *

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What is your ultimate goal for a Service Dog?*

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Please describe how your disabilities affect your life and you current level of independence.

Do you use any mobility aids? Please list each and how often used: Such as Wrist Brace, Manual Wheelchair, Power Wheelchair, Leg Brace, Knee Brace,  Prosthetics,  Walker, Hearing Aids, Other *

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Requested Tasks you would like Service dog to do for you? Alarm clock alert, retrieve items, turn on lights, provide stability control, Medical alert, behavior interruption, others*

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Once you are scheduled for your orientation, please be sure to bring a copy of the following documents with you. DD214 Military ID (if you have one) VA ID (if you have one) Drivers License*

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* Indicates required fields

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