• SERVICE DOG APPLICATION

  • Thank you for your interest in receiving a service dog from the Rescue 22 Foundation [R22]. R22 provides fully task trained service dogs to veterans that 1.) demonstrate need as documented by a medical professional and 2.) would benefit from a service dog as a therapeutic tool as part of a comprehensive medical or mental health plan.

    Each application is evaluated on its own merits. All information that is requested as part of this application is critical to ensure the best match possible in the selection of your service dog candidate. If you have any difficulty or have any questions for clarification while completing this application, please send an email to info@rescue22foundation.org and we will schedule an appointment via video conference to assist you.


    ALL INFORMATION GATHERED AS PART OF THIS APPLICATION IS KEPT STRICTLY CONFIDENTIAL AND WILL NEVER BE SHARED WITH A THIRD PARTY.

    To qualify for an R22 Service Dog, you must meet the following criteria (other acceptance criteria may be required upon review):
    i) Verifiable and documented diagnosis by a licensed and certified clinician or medical professional;
    ii) DD214 demonstrating honorable discharge, medical retirement or retirement from military service;
    iii) Stable living environment and the ability to financially support a service dog;
    iv) Free of substance abuse;
    v) Not have a conviction of any crime against animals.

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  • Am I a good candidate for a service dog?

    Will I make a good service dog handler?




  • Lastly, I understand that having a service dog is a huge committment. A service dog is not a pet and as such requires a great deal of additional time, effort and energy. 

    If at anytime you are unable or become unwilling to care for your service dog, the dog MUST BE RETURNED to the Rescue 22 Foundation.

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  • Medical and Mental Health Information

    Please be as precise and as thorough as possible, as this section greatly aids us in selecting and training a service dog that is best suited for your needs and goals.
  • CUES AND TASKS

    What are the trained tasks that would benefit you utilizing a service dog as an alternative therapy? (Please select all that apply).
  • Permissions

    Granting or denying the following permissions will have zero bearing on the acceptance of your application.
  • The information that I have provided is true and represents, to the best of my ability, a true depiction of my medical and mental health needs.

     

     

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