K9 Genius Service Dog Owner-Training Application
Please fill out this application to help us understand your needs and determine if our program is suitable for you.
Applicant Type
*
Myself
Someone else
My child/dependent
First and Last Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Preferred Pronouns
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
City/Area
*
Preferred Contact Method
*
Text
Email
Phone call
How did you hear about us?
Please Select
Google
Facebook
Instagram
Word of mouth
Veterinary referral
Current/past client
Other
What type of disability-related support are you seeking from a service dog?
*
How does your disability or condition impact your daily life, independence, or functioning?
*
What tasks or trained behaviors do you hope a service dog can provide? (Examples: retrievals, medical response, grounding, interruption behaviors, mobility-related support, alert/response work, or other disability-related tasks)
*
What are your main goals in pursuing a service dog?
*
Have you had or trained a service dog before?
*
Yes
No
If yes, please describe the outcome and whether that dog is still in your household.
Do you already have a dog you want to train as a service dog?
*
Yes
No
I am currently looking for a prospect
I am not sure yet
Dog's Name
Breed / Mix
Age
Sex/ Altered Status
Female
Male
Spayed Female
Neutered Male
Where did you get this dog?
Breeder
Rescue / shelter
Rehome
Family / friend
Other
How long have you had this dog?
Has this dog had any previous training?
Yes
No
Describe your dog’s general temperament.
How does your dog behave around unfamiliar people?
How does your dog behave around other dogs?
How does your dog behave in public or busy environments?
Has your dog ever shown any of the following?
Growling at people
Growling at dogs
Snapping
Biting
Lunging
Resource guarding
Severe fearfulness
Separation distress
Reactivity on leash
None of the above
Other
If you selected any concerns above, please explain.
Has your dog had any medical concerns, orthopedic issues, allergies, or ongoing health conditions?
Back
Next
Lifestyle Information
Please list all pets currently in the household. Include species, breed, age, and any relevant behavior notes.
If you have other dogs, please describe their behavior and whether they have any training or behavior concerns.
Who lives in the home?
Are there children in the home or children the dog will regularly interact with?
Yes
No
Maybe
Describe your typical daily routine.
How much time can you realistically dedicate to training each week?
Less than 1 hour
1–3 hours
3–5 hours
5+ hours
Unsure
Are you willing to follow a structured training plan between sessions?
Yes
No
Maybe
Which service are you most interested in?
Complete Service Dog Program
In-Person Service Dog Lessons
Virtual Service Dog Coaching
Service Dog Evaluation
Prospect Planning
Not sure yet
Are you looking for:
Long-term coaching through the full service dog development process
Help with a specific skill or issue
Help deciding if my dog is appropriate for service work
Help choosing a future prospect
Not sure yet
Service dog training often takes 1.5 to 2.5 years. Do you understand this is a long-term process?
Yes
No
I need more information
Do you understand that not every dog is suited for service work and that acceptance into training does not guarantee the dog will graduate as a service dog?
Yes
No
Maybe
Are you open to honest feedback if your dog is not appropriate for service work?
Yes
No
Maybe
Is your medical care team, therapist, psychiatrist, doctor, or other provider aware that you are pursuing a service dog as part of your support plan?
Yes
No
Maybe
If you feel comfortable, please explain.
Is there anything else you want me to know?
Please read and acknowledge the following: I understand that K9 Genius Training Co. does not sell fully trained service dogs. I understand that K9 Genius Training Co. does not certify service dogs. I understand that service dog training is a long-term process and outcomes are not guaranteed. I understand that not all dogs are suited for service work. I understand that this application does not guarantee acceptance into training. I understand that pricing and scheduling will be discussed directly after my application is reviewed. I confirm that the information provided in this application is accurate to the best of my knowledge.
Type your full name to confirm you have read and understand the above.
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