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 *

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

Civilain with PTSD/TBI/Mobility

Civilian with chronic illness

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

No

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

Yes

No

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

No

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 volunteers will contact you, usually within the next calendar month. 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 that will fit your lifestyle and help with your disabilities. The volunteer will arrange an opportunity for you to meet and observe a local trainer in action, allowing you to learn what will be expected of you.