Apply for a Dog

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Home
- Volunteer
Our Assistance Dogs
Apply for a Dog
About Us
Donate
Freedom Paws' Blog
- Team Training

Application Process

Online application request form

Application packet

Telephone interview

Medical/Professional reference

Personal interview

Selection Review

Waiting List

Assistance Dog Request Form

* Indicates required field

Name *

First

Last

Address *

City, State, Zip Code *

Birthdate *

Email *

Phone *

Best Day and Time to call *

What is your disability? *

How long have you been disabled? *

Type of Assistance Dog applying for *

Service Dog Skilled Companion Hearing Dog Diabetic Alert Dog Emotional Support Dog Facility Dog

Facility dog applicants only. Briefly describe your organization and your role there. *

What tasks or skills would you like an assistance dog to do for you or the recipient? *

Please describe how your disability effects your life and your current level of independence. *

What is your ultimate goal (or your goal for the recipient) with a possible partnership with an assistance dog? *

Name of person filling out form *

Have you identified a training assistant/facilitator *

Yes No

Are you a veteran? *

Yes No

If you have not heard from us within 24 hours after submitting this application please check your Junk email, or try emailing us at [email protected] *

Option 1 Option 2 Option 3

Submit

Home
- Volunteer
Our Assistance Dogs
Apply for a Dog
About Us
Donate
Freedom Paws' Blog
- Team Training