Service Dog Training Application
Owner Information
About the legal adult owner of the dog
Owner Information
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
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Dog's Health and Information
Information about the dog who will be trained to be a service dog
Dog's Information
Dog's Sex
*
Intact Female
Intact Male
Spayed Female
Neutered Male
Where did you get them?
*
Are they up to date on vaccines? (We will need a copy)
*
Yes, Only Rabies
Yes, All Recommended Vaccines
No, they are under 16 weeks old
No
Other
Are they on flea and tick preventives?
*
Yes, Year-Round
Yes, In Warm Months
No
Other
Are they on heartworm preventatives?
*
Yes, Year-Round
Yes, In the Warm Months
No
Other
Have they received any health testing? (Like OFA radiographs, PennHip Radiographs, DNA testing, Cardiac testing, etc.)
*
Have they been evaluated by a professional for service work?
Yes, and they said my dog was a good candidate for service work.
Yes, but they said my dog was not a good candidate for service work.
No
Was the Volhard puppy aptitude test performed on them as a puppy if so what score did they get?
Has your dog received any other formal training? If so, what methods were used and what did you work on?
*
What basic obedience are they still learning?
*
What basic obedience does your dog currently have mastered? (Meaning they do it 90% of the time every time you ask with or without treats present)
*
How does your dog behave whenever you leave home or leave the room?
*
How does your dog react to seeing another dog while on a walk?
*
How is your dog around children and infants if your dog has been around them?
*
How does your dog handle loud busy environments?
*
Does your dog have any behavioral issues that would need to be worked through before starting service dog training?(Like leash reactivity, resource guarding, etc)
*
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Handler Information
Information about the disabled handler of the dog
Is the handler the same as the owner?
*
Yes
No, the handler is the owner's minor child.
Other
Have you talked to your health care provider(s) about service animals? What have they said about you using one for your disabilities?
*
Yes, they approve of me utilizing a service dog
Yes, they approve of me utilizing an emotional support animal
Yes but they did not approve
No
Other
May Grey Matter Dog Training contact your doctor to discuss adding a service dog to your treatment plan?
*
Yes they may
No they may not
If we may who which doctor should we contact?
Are there any disability accommodations you will need as a client of Grey Matter Dog Training?
*
What generalized tasks are you wanting for your service dog?
*
Do you know any specific tasks you need from a service dog? If so what are they?
*
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