Pre-application Form for a Mobility Dog Logo
  • Pre-application for a Mobility Dog

  • INTRODUCTION TO MOBILITY DOGS
    Thank you for your enquiry to Mobility Dogs.

    Mobility Assistance Dogs Trust (Mobility Dogs) is a Charitable Trust established in 2003. Our Mission is to enhance the lives of people living with long-term disabilities, increasing independence, confidence, self-esteem and participation in New Zealand communities.   Mobility Dogs agree to treat all clients and applicants equally and aim to ensure that clients feel treated with attention, courtesy and respect.

    We achieve this through the following initiatives: undertaking the training of Mobility Assistance Dogs; providing Mobility Dogs to people living with disabilities and instructing them in the skills required to work with a Mobility Dog.

    THE SPECIALIST TASKS OF A MOBILITY DOG

    Our everyday work is focused on partnering highly skilled Mobility Dogs with individuals living with disabilities including, but not exclusive to, cerebral palsy, multiple sclerosis, muscular dystrophy, spinal injury, stroke, and Parkinson’s. Mobility Dogs are trained in a range of specialist tasks such as:

    • Retrieving and delivering items
    • Paying for purchases across a counter
    • Assisting with taking off clothing ie. socks, jackets, dressing gowns etc
    • Opening and closing doors, cupboards and drawers
    • Carrying items
    • Pressing buttons ie. pedestrian and restroom buttons
    • Depositing items into baskets and containers
    • Barking for help on command
    • Delivering items from one person to another

    We recommend you go to our website www.mobilitydogs.co.nz as you will gain an overview of the Trust. There are several client stories that will give you a sense of what to expect from being partnered with a Mobility Dog.

    ELIGIBILITY CRITERIA

    • Applications for Mobility Dogs will be considered regardless of race, sex, religious preference or sexual orientation
    • Primary disability must be a physical disability
    • A dog can enhance daily life by undertaking functional tasks
    • To be able to adequately manage and care for a dog and have key support person(s) supporting the placement
    • Home environment is suitable for housing a Mobility Dog

    COSTS

    Whilst the cost to raise and train a Mobility Dog is met by the Trust, there is a placement cost of $10,000 which contributes to associated placement costs if you receive a dog. Should you be accepted into the program, the Client Coordinator -Applicants can give you the steps to follow to apply for funding. Applicants who successfully move into stage three of the application process will also incur the cost of a Functional Assessment. Once our dogs are placed with clients all ongoing costs of the dog are met by the client and we recommend you seek Pet Insurance cover. On average the ongoing costs are approximately $3000 per year.

    TIMEFRAMES

    Due to demand for a Mobility Dog and individual client requirements we are unable to provide set timeframes for completion of the application process.
    We undertake to:
    • Keep applicants informed throughout the application process
    • Respond to any enquiries promptly
    • You will be advised of the final outcome by Mobility Dogs when the Mobility Dogs team have reviewed and assessed all your documentation
    • If you are successful we then begin a process of looking for a suitable Mobility Dog with the training, skills, personality and physical requirements to match your needs 

    THE PRE-APPLICATION PROCESS

    Please note that filling out this form does not guarantee you will be suitable to receive a Mobility Dog. We do not accept applications from people under the age of 18. 

    Please be aware that at any time and for any reason you can choose to withdraw your application. 

    The process for receiving a Mobility Dog is divided into three separate stages outlined below. As each stage is completed and reviewed by the Mobility Dogs team, you may be asked to continue to the second and finally the third stage or be advised that your application is not proceeding to the next stage.

    We understand that this can be a lengthy process for you, however we aim to ensure that a Mobility Dog is appropriate for your specific situation and will enhance your life.

    • All applicants will be considered for a Mobility Dog in accordance with our Equal Opportunities Policy.  All applications will be considered regardless of a persons race, sex, religious preference or sexual orientation.
    • All applicants will be treated with respect and fairness in accordance with Principal 2 of Mobility Dogs Code of Ethical Conduct

    APPLICATION STAGES

    Stage 1 – Pre-application Form

    Please complete the pre-application form in full and press Submit at the end.
    Our team generally reviews applications monthly. We may contact you if we need further information.

    If your application does not proceed, you will be advised of the outcome.
    If you have any questions about the form, please contact the Client Team by phone or email. 

    Stage 2 – Home Visit or Online Meeting

    If you progress to Stage 2, we will coordinate a home visit or (depending on your location) an online meeting with our Client Team.

    For the home visit, we recommend you invite any support people, friends, family, or carers who would be involved in supporting you with a Mobility Dog.

    Having a Mobility Dog in your life can be very rewarding. However, the dogs require a great deal of time, care and attention from you. Sometimes living with a disability means care of a dog can be challenging. It is during this meeting that we can discuss how this will be managed by you or your support people.

    The cost of the dog will also be discussed at this stage.

    After the visit/meeting, the team will review your application again. You will be contacted by the Client Team to confirm whether you will proceed to Stage 3.


    Stage 3 – Functional Assessment

    The Functional Assessment helps confirm whether you are a good candidate for a Mobility Dog and informs the matching process.

    Assessments are carried out by a Physiotherapist or Occupational Therapist. Our nominated provider, Neuro Rehab Results (Auckland), offers both in-person and Telehealth assessments. If you cannot travel to Auckland, we may arrange for a local provider in your area. We will advise the most suitable option for your circumstances.

    The assessment takes about one hour and covers your current physical function, how a Mobility Dog may impact it, and includes some routine functional tests.

    Cost: Approximately $300. You will need to pay the provider directly. If using Neuro Rehab Results, payment is required before confirmation and at least 7 days prior to the appointment. Other providers may have different payment terms, which you must meet.

    Once the Functional Assessment is complete, the Mobility Dogs team will review all information gathered throughout the process and advise you of the outcome and any next steps.

  • If you are successful in your application Mobility Assitance Dogs requires confirmation from our clients that they can adhere to the terms and conditions below:

  • If you are unable to meet any of the above requirements please contact the Client Coordinator Team - clients@mobilitydogs.co.nz to discuss this further.

  • Personal Information

  • If you are an existing client applying for a Succession Dog, thank you for your new application to Mobility Dogs.  We know you have been working with your dog for a long time now and it’s not an easy transition when you recognise it’s time for them to retire.  We will help you through this process to make it as easy for you and your dog as we can.  We need to ensure we have all your details correct and any changes to your circumstances or requirements are recorded so please complete the application form again in full making sure to complete any additional questions specific to a Succession Dog application.

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  • Medical Information

  • Please provide as much detail as possible.

  • Existing clients applying for a Succession Dog to complete:

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  • An Important Consideration
    If it is not possible for your current dog to remain with you when you are matched with a succession dog we need to think about who would care for your dog in its retirement.  There are several options we can talk through with you, for example:  staying in your home or being re-homed with a friend or family member are the most common.  Please make contact with your Client Coordinator to discuss your situation and support you with a plan moving forward.

  • Abilities and Limitations

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    • Mobility Aids used 
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  • Lifestyle

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  • Home Environment

  • Your Experience With Dogs

  • Employment/Tertiary Education

  • The Mobility Dog

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  • Pre-Application Agreement

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