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PTSD SERVICE DOG
APPLICATION

ATTENTION: READ BEFORE APPLYING

This is an application for Indiana residents to receive a PTSD Service Dog from our organization at no cost.

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It will take us up to a few months to review your application, and unfortunately there are many that we have to turn down. If your application is approved, it will be a few years before you receive your fully trained service dog.

If you're interested in learning more about training your own PTSD service dog, click here

Personal Information

Date of Birth
Month
Day
Year
Are other animals living in the house?
Yes
No
Do you plan of leaving the state of Indiana within the next 2yrs?
Yes
No
Unsure
Do you have an extra $200 a month to care for a dog?
Yes
No
Not sure
Are you currently working with a therapist?
Yes
No
Not right now, but I plan to
Not right now, and I don't plan to
Do you foresee any challenges potentially coming to Indianapolis for an in-person interview?
No
Yes
What is your gender identity?
Male
Female
Non-Binary
Other

File Uploads

Tax Return: While economic instability doesn't disqualify you from reciving a dog, we want to make sure any dog we place goes to a reliable home. Please upload your most recent tax return to go with your application.

Personal Essay: Please provide a response to each bullet point item. You can write more if you like, but we at least need your thoughts on these questions to determine how we can help you.

a.) How do you see a service dog helping you?

b.) Why are you seeking a service dog now?

c.) How will a service dog fit into your day?

d.) What is it about our program that seems like a good fit for you?

e.) What other treatment(s) have you sought for your PTSD?

Video of Home: Record at least a 3min video of your living situation and where the dog would be living. Feel free to include anything else in this video you think is relevent.

Letter From a Friend: Choose a friend, family member, or coworker to provide a one page letter explaining how they feel a service dog would fit into your life and how a service dog would enhance your support system.

PTSD Symptoms

Finishing Up

How did you hear about us?
Service Dog Application

This application will take you several hours to complete, and we ask for several files and documents. Please review what is asked for before getting started, because once you do you won't be able to save your progress.

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