Send
Section 1 of 3
Apply for a Service Dog
If you need assistance completing this form contact us! ServiceDogsz CO does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations.
This form is automatically collecting emails from all respondents.Change settings
Section 2 of 3
Untitled Section
Section 3 of 3
What are your reasons for requesting for a Service Dog?
I have autism and mobility issues.  I previously had a program dog, but she washed for fear of cars.  
The cost to train a service dog is between $8000-$15000. How do you plan cover the cost of training tuition?
Question Type
Loading image…
I plan on making payments
Add option
or
add "Other"
Answer key
(0 points)
Loading...
Loading…
Link to Sheets
Message for respondents
This form is no longer accepting responses
Insights
Total points distribution
Loading...
Loading responses…
Settings
Release grades
Respondent settings
Global quiz defaults
Default question point value
Point values for every new question
points
Responses
Manage how responses are collected and protected
Presentation
Manage how the form and responses are presented
Defaults
Form defaults
Settings applied to this form and new forms
Question defaults
Settings applied to all new questions
.