PAWSITIVE INDEPENDENCE INC.

Service dog application

Tell us about the support you are looking for. Submitting this form is an enquiry and does not guarantee eligibility, funding or placement.

Tell us about yourself

Fields marked * are required. Your application is stored in the DOG database for review.

Full name *

Email address *

Phone number

Country *

Why are you applying for a service dog? * What type of support is needed? * Which dog are you interested in? * Which platform did you find us from? * Do you have additional comments, questions or concerns?

Do not include passwords, financial details or unnecessary medical records.