Service Dog Application

Please Fill Out The Form Below To Submit Your Service Dog Application.👇

Let's Get Started!

Step 1 of 7 General Information

Date of Application *

Full Name *

Email *

Phone *

Date of birth *

Step 2 of 7 Contact Continued...

Address *

City *

State *

Postal code *

Step 3 of 7 Veteran Status

Please check all that apply *

Veteran

First Responder

Branch or Department *

Disability *

Type of request *

Requesting a service dog be provided

Requesting my own dog be trained as a service dog

Step 4 of 7 In Home Considerations

Other animals in home *

Other People in the home *

Owned a dog before? *

Step 5 of 7 Dog Care provisions

Primary responsibility for dog's care *

Financial responsibility for this dog *

Do you agree to provide regular healthcare by a licensed Veterinarian? *

Yes

Are you willing to take the responsibility for this dog for the next 10 to 15 years *

Yes

Step 6 of 7 Dog Care Provisions Continued

Care Provisions *

How did you hear about South Dakota Service Dogs

Is there anything else you would like us to know?

Step 7 of 7 Agreement & Acknowledgement

If selected for this program I can provide 3 references *

Yes

I agree all statements are truthful *

I agree that all statements above are truthful and accurate to the best of my knowledge

Signature *

Clear

Once you have submitted your application, one of our staff members will contact you. They will review your application, answer any questions, and seek any clarifications needed. They will then review this information with the local trainers to determine if we can proceed with matching you to a dog or evaluating your own dog.