New Basic Service Dog Request


Client Contact Information
A Client is the recipient of the services provided by the Canine Companions service dog.
PLEASE NOTE:
Canine Companions requires all people applying for a service dog to be at least 18 years of age; those applying for a service dog with a facilitator must be at least 5 years of age.  

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Contact Information - Completing for Client





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 Some of the tasks Canine Companions' dogs are trained to do:
  • Retrieve and deliver dropped items.
  • Tug open a door or drawer.
  • Tug a laundry basket or help remove a sock or jacket.
  • Push with their nose to shut a drawer or open a door with an automatic push plate.
  • Pull a lightweight manual wheelchair over a short distance. (Adult service handlers only.)
  • Turn lights on and off.
  • Our hearing dogs alert those who are d(D)eaf or hard of hearing to various sounds in their environment.
  • Our service dogs for veterans with PTSD are trained in nightmare and anxiety interruption, among other skills.
I understand Canine Companions DOES NOT train or place dogs for the following:
  • Guide work for the blind. 
  • Medical alert/response, including but not limited to seizures, diabetes, heart rate.
  • Balance support while walking.
  • Managing specific behaviors such as stimming, eloping, etc.
  • Provide supervision, navigation, or safety from environmental hazards, aggression or personal protection.
  • Solely for emotional comfort or social support, such as anxiety and/or depression. At this time, Canine Companions does not make placements with civilians diagnosed with PTSD.
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Canine Companions has enrollment qualifiers that must be met to proceed to the next step in the application process. Check ALL the following boxes to acknowledge you meet these requirements.  If you do not meet each of these qualifiers or wish to not proceed, please close this page and your personal information will not be saved.
Facility Details