COLLAB Dog Training: Owner-Trained Service Dog Application (In-Person Program) Form

Section 1: Applicant Information - I am submitting this application for:*

Myself

Someone else

Full Name of who the service dog is for:*

Full name of handler (if different than above)*

Date of Birth:*

Preferred Pronouns:*

Phone Number:*

Email Address*

Home Address:*

How did you hear about COLLAB Dog Training?*

Briefly describe your disability/disabilities:*

Date of Onset:*

How does your disability affect your daily life and independence?*

Is your medical team aware and supportive of you adding a service dog to your treatment plan?*

Yes

No

Unsure

Note: A letter from your medical provider will be required to confirm disability status.*

Check the box if true

Section 3: Dog Information - Do you currently have a dog you want to train as a service dog?*

Yes

No

Considering

Dog’s Name:*

Breed or mix (if known, otherwise best guess is ok)*

Age / Date of Birth:*

Sex & Reproductive Status (intact, neutered, spayed):*

Weight:*

Microchip/Tattoo/License #:

Date of Neuter/Spay (if applicable):

Vet Clinic Name:*

Does your dog have any current or past medical conditions?*

Yes

No

Vet’s Email Address (we will reach out to your vet for confirmation of health)*

Has your dog seen a veterinarian recently?*

Yes

No

Scheduled soon

What tasks would you like a service dog to perform?*

What are your goals in having a service dog?*

Have you trained or lived with a service dog before? What was the outcome?*

Please list all other pets in your household. Include age, species, breed, and any behavioral concerns:*

If you own other dogs, please describe their behavior, whether they are intact, and any other relevant information:*

Previous Training (if any):

What do you do when your dog does something they shouldn’t do:*

What types of misbehavior does your dog engage in?*

Emergency Contact for Your Dog (Name, Address, Phone):*

Dog’s Food & Feeding Schedule:*

Special Diet or Medications:*

Allergies or Intolerances:*

Describe your dog’s unique personality, sensitivities, and preferences:*

What kind of early socialization did your dog receive (if known)?*

What kinds of training methods and tools have been used?*

What behaviors have worked well for your dog?*

Has your dog had any traumatic or negative experiences?*

How does your dog respond to new training or environments?*

Describe your home and daily environment (apartment, yard, noise level, etc.):*

How many hours per day is your dog inside vs. outside?*

Describe your dog’s current exercise, enrichment, and social opportunities:*

Are there any stressors or triggers in your home or routine?*

Yes

No

What breed traits or instincts does your dog demonstrate (e.g., guarding, herding, chasing)?*

Do you think these traits are helping or hindering your training goals?*

Yes

No

Are there natural behaviors you’re struggling to manage at home or in public?*

Yes

No