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Service Dog Application

We train free service dogs for people with physical disabilities other than blindness, focusing specifically on mobility assistance, and hearing alert.

We carefully select mixed breed pups from rescue groups to train as our service dogs.

Each dog is uniquely trained to perform tasks to assist their matched recipient. Our service dogs will walk next to their person on a loose leash – no pulling or lunging,  assist their person in going up and down stairs, assist their person to restabilize their balance, retrieve a dropped item, fetch items, open drawers, doors – whatever their person requires.

If you require a hypoallergenic, hearing alert, or seizure alert service dog, or an emotional support dog, please contact us at info@putnamservicedogs.org. We’ll recommend other sources for you to find your dog. 

We seek applicants who will benefit from a mobility assistance dog, and who can competently and humanely care for a dog, 

Currently, the wait for our Service Dogs is about 2 years, depending on your home situation, needs, and the capabilities and temperament of our pups graduating.

We need volunteer puppy raisers and vacation fosterers to produce our Service Dogs! Please ask your friends to apply. 

 To apply, please complete the following application. All required fields * must be completed for the form to submit.

Please note that applying does not guarantee you will receive a service dog. 

Any misrepresentation(s) on the application will result in disqualification of the application.

SERVICE DOGS FOR VETERANS
BECOME A VOLUNTEER PUPPY RAISER
FACILITY DOG APPLICATION
ADOPT A RELEASED DOG
VACATION RELIEF VOLUNTEER APP

    Your Name and Address

    Salutation* :

    Are you a Veteran? YesNo

    Under 21 or incapable of competently caring for a dog?*YesNo If no, please add custodial parent or guardian contact info.

    Custodial Information

    Salutation :

    I approve all communications going to both me and my guardian.

    Additional Contact Information

    Would you like to add an additional contact?*YesNo If yes, please add below.

    Salutation*:

    About You

    Do you require a Hearing Alert Dog?*YesNo

    Do you require a Seizure Alert Dog?*YesNo

    Do you require a Hypoallergenic Dog?*YesNo
    (Please answer yes to this question only if you REQUIRE a hypoallergenic dog)

    Are your living arrangements conducive to caring for a Service Dog?*YesNo

    Explanation*:

    How will you exercise the dog?*

    Do you have a support system (family and/or friends) to assist with transitioning to life with our Service Dog and with the responsibilities of owning a dog?*YesNo

    Explanation*:

    A Service Dog will cost $1,500+/year to feed and provide vet care. Can you afford this?*YesNo

    Explanation*:

    Will the applicant (and Parent/Guardian/Caretaker if relevant) be able to attend a 5 day training session in Putnam County, NY? You will be responsible for room and board during this period with some assistance from us.*YesNo

    Explanation*:

    Your Personal Information

    Your Birth date*:

    Your Height*: ' " (Feet/Inches)

    Your Weight*:

    Marital Status*: SingleMarriedWidowed/WidowerDivorced

    Who else lives with you? (People and animals)*

    Note: Since another dog in the household will distract our Service Dog, we are only placing Service Dogs in homes that have no other dogs.

    Is anyone in your household allergic to, or afraid of dogs?* : YesNo

    If yes, please explain below:

    Type of Home you live in* : ApartmentHouseOther

    Fenced Yard?* : YesNo

    Type of Area you live in* : UrbanSuburbanRuralOther

    Explanation*:

    Type of Area you and your Service Dog will visit frequently* : UrbanSuburbanRuralOther

    Explanation*:

    List any Medical Condition(s)* :

    Please enter none if no conditions exist.

    Disabled?* : YesNo

    If Yes, How long have you been disabled?*

    How does your disability affect your life and current level of independence?*:

    List the type of activities you want your Service Dog to assist you with

    Retrieve and deliver dropped items?* : YesNo

    Fetch Items?* : YesNo

    Explanation*:

    Turn lights on and off?* : YesNo

    Assist you in dressing?* : YesNo

    Assist you in doing the laundry?* : YesNo

    Go for help in case of an emergency?* : YesNo

    Open doors?* : YesNo

    Open drawers?* : YesNo

    Press elevator buttons?* : YesNo

    Accompany you in crowded situations?* : YesNo

    Explanation*:

    What other activities were you hoping your Service Dog would perform?*

    Name of person completing this form and contact information (Phone and email)

    Salutation*: