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Veteran application

Thank you for taking the time to complete our application. Submitting an application does not guarantee acceptance into the program, but it does begin our interview process. Please allow up to 3 business days after submission for a member of our team to contact you to schedule an interview.

Veteran Information

Birthday
Month
Day
Year
Preferred Contact Method

Military Service

Branch of Service
Discharge Status
Do you currently receive VA care?
Yes
No

Support Needs

What challenges are you hoping a service dog may help with?
Are you currently working with a therapist/VA provider/Medical Professional?
Yes
No

Lifestyle & Readiness

Do you have stable housing?
Yes
No
Do you have other pets?
Yes
No
Are you able to attend training sessions and follow program requirements?
Yes
No

Expectations & Commitment

Consent & Acknowledgment

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