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Kobe’s K9's Service Dog Application

Thank you for your interest in Kobe’s K9's. Our mission is to provide professionally trained service dogs to children undergoing cancer treatment — offering them comfort, companionship, and emotional support during a difficult time.

This application helps us learn more about your child, your family, and how we can best match you with one of our service dogs. Please answer honestly — there are no right or wrong answers. We know every family is unique, and we do our best to accommodate individual needs.

If you have any questions while filling out the form, feel free to reach out to us directly at shelby@kobesk9.com 

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Section 1 : Parent/ Guardian information
Full Name of Parent/Guardian
 *
Parent/Guardian Phone Number
 *

Parent/Guardian Email Address

 *

City and State of home address

 *
Section 2: Child’s Information

Child’s Full Name

 *

Child’s age

 *

Child’s gender

 *

Diagnosis / Medical Condition

 *

Treatment Facility

Current Stage of Treatment

(e.g., newly diagnosed, in treatment, remission, etc.)

 *
Section 3: Family & Home Environment

How many people live in your home?

 *

Do you currently have any pets?

*

If yes, does your current pet work well with other animals?

Do you have a fenced yard or a safe outdoor space?

 *

Do you have someone who can care for the dog during extended hospital stays?

 *
Section 4: Readiness & Fit

Why do you feel your child would benefit from a service-trained dog?

 *

Is your child comfortable around dogs?

 *

Are there any concerns we should be aware of

(allergies, fears, behavioral challenges, etc.)?

 *

Is your family prepared to care for a dog long-term (10+ years)?

*
Final Section! 
I understand that this is not a guarantee of placement and that final decisions are based on fit and availability. *
Required
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