Assessment form to apply to Solstice Service Dogs waitlist
This is a pre-screening questionnaire that is required to be approved for the program. It does not guarantee waitlist placement.
Legal Name (nickname in parentheses)
*
First Name (Nickname)
Last Name
E-mail
*
Confirmation Email
example@example.com
Phone Number
DOB
-
Month
-
Day
Year
Are you applying for a finished dog or started dog
*
Please Select
Finished
Started
Started dogs are only accepted on a rare case by case basis
Please list any current household pets (Age, Species, gender)
*
Where did you hear about us?
What is your ideal timeframe/ wait time to bring home a Service (if you have an ideal calendar year to graduate include it)
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your budget? Keep in mind majority of programs often charge $25,000+ for placements
*
Are you able to complete payment upon acceptance, or do you need a payment plan
Describe your home environment Apartment or house? do you have a fenced in yard?
Are you disabled with a condition that effects atleast one or more major life functions? Please describe how your disability effects your daily life functioning and how you think a service dog could help mitigate your disability (this is private information that will not be shared, it is required to help pair the right dog with the right handler)
What task do you think the dog could preform for you that would be beneficial?
Please list all members of your residence, their ages, and if they’re okay with new dog.
Can you provide references? Reference are people that can vouch for you, and say that they think you’re capable of caring for a dog etc. please have reference sent to Jc@solsticeservicedogs.com
Do you have any questions?
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