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Child Client Application

This application is for both children under 18 and individuals who are older but not their own legal guardian. The majority of 4 Paws placements operate as a 3 unit team (parent/handler, child/partner and service dog), with the handler using the service dog as a tool to assist the partner. Please carefully fill out this application. Only fully completed applications with submitted health forms and reference letters will be processed. Upon receiving your application you will receive an email receipt with links for the additional needed forms!

Once all components of an application have been received, the application will be processed. Upon acceptance, the handler(s) is required to met their fee for service which goes toward the mission of 4 Paws. Most families meet the contribution requirement through fundraising. After you have reached your fee for service, you will be placed in a spot in the next open placement training class to receive your service dog. Currently these classes are full about 2 - 2.5 years out.


Child Information

Parent/Legal Guardian Information

Emergency Contact Information

Medical Information

Physician Information

If Applicable:

Service Dog Certification

Three Unit Team: Most 4 Paws placements are with children needing support, and 4 Paws has developed a three unit team (Parent/Handler, Child and Service Dog) to meet their needs. This is the case for all situations where a child may be affected cognitively, behaviorally or intellectually. The Parent/Handler must be present with the child in public and will be the one handling the service dog for the benefit of the partner. 

Two Unit Team: To be the handler of the service dog, the individual must be capable of making 100% correct choices for themselves and the service dog to the same capacity of an adult. A two unit team certification is given when the child has fully shown complete ability to make correct choices in public for themselves and the service dog as displayed in the Placement Training Class. The youngest that this will typically be considered is 12 years old. 

Please visit our website at to identify the right type of service dog you need.


4 Paws for Ability requires that families maintain a high level of care with their service dog. It is expected that your dog will be fully up to date on all medical care, provided a high quality diet, maintain a healthy weight and be properly groomed. To accomplish this expectation requires a family to be prepared for a cost around $1,500-2,000 each year.

Employment Information

Household Information

Pets & Veterinary Information (Past & Present)

4 Paws for Ability requires that all pet dogs within the home are: up to date on vaccines, receive monthly heartworm medication, friendly towards other dogs, inside dogs, and that the number of dogs in the home does not exceed three dogs by the time that the service dog would be placed in the home. Applicants understand that they are agreeing to not add any additional pet dogs to the home within 6 months before and after receiving the service dog.


4 Paws for Ability does not discriminate based on any demographic information provided. The voluntary completion of this information supports the ability of 4 Paws to seek funding from grants and other sources that require demographic information to measure outcomes.

Additional Information

The total cost of breeding, raising, and training a service dog is between $40,000 -$60,000. Clients are only asked to contribute a portion of that cost.  Click here for our current fee for service  I understand that upon acceptance into the 4 Paws for Ability program, I will need to meet my fee for service. 4 Paws reserves the right to use non identifying applicant information for fundraising purposes to raise the remaining funds needed to place the service dog. Information may include, first name, disability and state.

I understand that after I have met my fee for service, I will be placed in the next open placement training class to receive my service which can be at least 2 - 2.5 years due to class availability as well as the time it will take 4 Paws to breed, raise and train my service dog.

4 Paws reserves the right to deny services to any applicant which doesn’t meet the criteria necessary for placement of a service dog or who requires services not trainable within the guidelines of the agency.

Contact info:, (937)374-0385, or

APPLICATION MUST BE ACCOMPANIED BY A $50.00 NONREFUNDABLE PROCESSING FEE. If you encounter any problems when processing the fee, please immediately email Thank you! APPLICATION MUST BE ACCOMPANIED BY A $50.00 NONREFUNDABLE PROCESSING FEE. If you encounter any problems when processing the fee, please immediately email Thank you!
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