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Veteran Client Application

This application is for Veterans of the United States Armed Forces who would be operating as the primary handler of the service dog within three hours of Xenia, OH. Please carefully fill out this application, only fully completed applications with submitted DD214, 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! This email will be going to the email provided in the first section of the application
 

Personal Information

All of the contact information under the Veteran will be the primary way that 4 Paws contacts you regarding the application process as well as communication going forward. 

Emergency Contact Information

Spouse/Sponsor Information

What is the relationship of this person to the client?

Medical Information

Physician Information

If Applicable

Description

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Employment Information

Spouse/Sponsor's Employer's 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 from now until at least one year after the service dog is placed to give the service dog time to adjust and bond appropriately.

Maintaining a Service Dog

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. 4 Paws for Ability is not currently a member of Assistance Dogs International. The VA uses membership as the determining factor of whether they will financially provide for the dog's care. 4 Paws for Ability Veteran Applicants should be prepared for a cost of around $1,500-$2,000 each year in caring for their service dog. 

Service Dog Information

To be the handler of the service dog, the individual must be capable of making 100% correct choices for themselves and the service dog.

Demographic

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:

Clientservices@4pawsforability.org

(937)374-0385

www.4pawsforability.org

APPLICATION MUST BE ACCOMPANIED BY A $50.00 NONREFUNDABLE PROCESSING FEE. If you encounter any problems when processing the fee, please immediately email MattFrederick@4pawsforability.org. 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 MattFrederick@4pawsforability.org. Thank you!
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Client Application Fee

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