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Service Dog Request
Please complete the form below to submit your request.
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Name
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Address
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Email
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Select Preference
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Puppy
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Male
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Breed
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i.e. German Shepherd, Labrador Retriever, no preference, etc.
Disability the Dog Will Serve
*
i.e. epilepsy, autism, mobility impairment, blindness, etc.
Training Support in the Area
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No
Yes
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Will there be training support for the service dog in your area?
Comments
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Please share the individual's story and how you hope they will benefit from a service dog.
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