Owner-Trained Service Dog Program · Psychiatric, Autism, Medical & Mobility

Handler Intake

The start of a real partnership - 12 to 24 months building a working public-access team with the dog you already love. This helps me prepare for an honest, focused intake call.

Share only what you’re comfortable with. Your privacy and dignity come first - nothing about your disability is ever shared without your explicit say-so. The signable program agreements are handled separately.

Handler & contact

Your name *

Phone

Email *

City / location

In-person or hybrid?

Weekly training availability how much you can train between sessions

About your situation

Disability area the tasks would address only what you’re comfortable sharing - e.g., PTSD, anxiety/panic, mobility, medical

Currently working with a provider? optional - helpful for task planning

About your dog (the prospect)

Dog’s name

Breed / age / sex

Spayed / neutered?

Source / history breeder, rescue, how long you’ve had them

Food drive (1–10)

Toy / prey drive (1–10)

Temperament in a few words

Known sensitivities sound, surfaces, strangers, other dogs?

Reactivity / neutrality reacts to people, dogs, or noises?

Health & vaccination

Current vaccinations and a clean bill of health are required before training begins (and before any board & train). Have your vet records ready.

Rabies current?

DHPP / DAPP current?

Bordetella current?

Recent vet wellness exam?

Flea/tick & parasite prevention current?

Primary veterinarian / clinic

Known medical conditions

Cleared for weight-bearing work? needed before any brace/mobility tasks

Goals & the tasks your dog will learn

Idea bank - Psychiatric: deep pressure, tactile grounding/interruption, blocking & cover, room search/“all-clear,” interrupt a nightmare, medication reminder, guided exit, crowd buffering. Mobility/medical: retrieve meds/phone/keys, medical alert & response, get-help/button, momentum or counterbalance (vet-cleared), tug doors/laundry.

Task 1 you need *