Client Application Forms

Assistance dog for a person who has mobility and/or balance problems:

This type of dog can assist an individual who may use a wheelchair, cane or walker or have an unsteady gait.  The dog may perform tasks such as picking up dropped items, retrieving items off counters, turning light switches on and off, carrying items in a backpack, tugging open doors, alerting for help, pulling someone using a manual wheelchair up ramps or short distances, etc. These dogs have full public access rights under the Americans with Disabilities Act.

Assistance Dog for Mobility Application and Medical History Form


Assistance dog for a person with autism:

This type of dog can be trained to assist those with autism to better cope with public situations. These dogs are taught to apply deep pressure relief and comfort by pressing on a leg or lying on a person’s lap. They may also be used to encourage a person with autism to stay with their family member in public by providing a handle or leash for the person to hold and aid with increasing social and life skills. These dogs have full public access rights under the Americans with Disabilities Act.

Assistance Dog for Autism Application and  Medical History Form


Assistance dog for a person with PTSD:

This type of dog is taught behaviors that help people with PTSD to better cope with fear and anxiety. These dogs can provide a physical barrier between their partner and the public, provide stress reducing pressure on trained body points and provide a social bridge as a point of conversation. These dogs have full public access rights under the Americans with Disabilities Act.

Assistance Dog for PTSD Application and Medical History Form


Facility dog to help professionals who work with people with disabilities:

The professional may work in education, counseling, social work, physical therapy, occupational therapy, nursing, ministry, etc. These dogs may serve as innovative teaching tools, motivation, therapy catalysts, rewards for achieving goals, and unconditional love.  These dogs do NOT have public access rights.

Facility Dog Application and Medical History Form


Home skilled companion dogs:

This type of dog is trained to help in home settings only. They may assist with in-home tasks similar to Type 1 or Type 2 (as listed above) such as assisting a person with autism or with intellectual disabilities in the home setting to foster bonding relationships and assist with therapies and life skills development. These dogs do NOT have public access rights.

Skilled Home Companion Dog Application and Medical History Form

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