Demande D'entrainement

Request For Training

Vérifier Votre "Poubelle"

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Email

info@doginspired.ca

Contact Details

First Name / Nom *

Last Name / Nom Famille *

Phone *

Select an Address *

Email *

Dog's name / Nom du chien *

Age *

Breed / Race *

Service *

Virtuelle/Virtual

Cours de groupe / Group classes

À domicile/In-home

Where did you hear about us? / Comment avez-vous nous trouvé? *

Message

Langue préférée/ Preferred language *

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Service Dog Training Application

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Email:

info@doginspired.ca

Service Dog Training Application

First Name *

Last Name *

Preferred Pronouns *

Phone *

Email *

Address

Street Address *

City

State

Country

Postal code

What type of service are you interested in? *

Virtual training

In-Person Training

Virtual & in-person

Information about the person needing the service dog.

Who is the dog for? *

Age of handler (Must be 18+ yrs) *

Your Daily Activity Level *

Describe your home and social life, hobbies, activities...etc. *

What sort of transportation do you use? *

Please briefly describe your disability(ies) *

Do you have a medical condition that could require intervention? (ie: seizures) *

Do you have other pets at home? *

By signing below, I authorize the release of any requested information regarding my health to Dog Inspired. The information given will not be used for any other purpose than to evaluate and assess my condition as it relates to the owner-trainer service dog training program. Dog Inspired will keep this information confidential and will not share it with anyone except the professional staff involved in helping provide services for me.

Upload referral by a registered healthcare professional.

Your dog's details

Dog's Name *

Dog's Age *

Dog's Breed *

Dog's Sex: *