Service Dog Application

The Service Dog Application must be mailed. To request a copy of the Service Dog Application  forms, please submit the request form below:

    First Name (required)

    Last Name (required)

    Your Email (required)

    Confirm Email Address

    Address


    City

    State

    Zip

    Day Time Telephone

    Cell phone

    Preferred Contact Method EmailDay Time TelephoneCell Phone

    How could a Service Dog assist you?:

    Are you a: VeteranFirst Responder*Civilian

    *Please note that we classify first responders as: Police, Fire and EMS only.