Take the First Step Toward a Powerful Bond

Service Dog Training Application

Apply below to the K9 Partners for Patriots 6-month service dog training program.

Before You Begin

To complete the K9 Partners for Patriots Service Dog application process, you must upload two completed medical release forms:

One completed by your Primary Care Provider
One completed by your Mental Health Provider

The forms are available for download below.

The following forms must be completed before you submit your application.

You will be asked to upload them near the end of the application.

Please download the required forms and make sure they are completed and ready to upload before continuing.

Download Primary Care Provider Medical Release Form

Download Mental Health Provider Medical Release Form

K9 Partners for Patriots is not affiliated with the Department of Veterans Affairs (VA) and the VA does not fund our program. Acceptance into our program is based on a clinical diagnosis of PTSD, TBI, or MST — not on VA disability ratings.

Qualifying Criteria



Active Duty or Veteran of the United States Armed Forces

Veterans or service members of foreign armed forces do not qualify.



Honorable Discharge

DD214 long form stating character of service. General under honorable conditions do not qualify.



Diagnosis of PTSD, TBI, or MST

Medical release forms completed by your physician, counselor, or VA.



Individuals with felony convictions, or a history of domestic violence, sexual offenses, or any form of animal mistreatment, abuse, neglect, or cruelty are not eligible.

Begin Application

Application Spans Multiple Pages

Navigate through all the pages until you reach the “Submit” button. Once your application is successfully submitted, you will see a “Success” confirmation. Refer to the progress bar located at the top of each page to track your progress throughout the form.

Name Change

If the name on your driver’s license doesn’t match the name on your DD214 you will be required to provide legal documentation for the name change. i.e. marriage, divorce, or name change affidavit.

Begin

"*" indicates required fields

Step 1 of 9 - Qualifying Requirements

Required Acknowledgement*

I understand that I must have both completed medical release forms ready to upload before I can submit this application.

Terms of Use Agreement

Initial Below*

You must understand and agree to the following Terms of Use to be eligible to participate in the K9 Partners for Patriots Service Dog Training Program.

I understand if I do not attend my assigned classes with my dog (with the exception of injury or illness), I will be removed from the program. If the dog was donated to me by K9 Partners for Patriots, it will be returned to the program as well.

INITIALS:

Initial Below*

I understand that I must have an email account that I check on a regular basis as being a critical requirement for enrollment in the program. I understand that without a reliable email account, K9 Partners for Patriots will not be able to communicate important messages and updates to me.

INITIALS:

Initial Below*

I understand that FIREARMS ARE PROHIBITED in the K9 Partners for Patriots Facility. Various training scenarios and activities could cause concealed weapons to become dislodged and pose a safety concern.

K9 Partners for Patriots strongly supports the 2nd Amendment and encourages the lawful carry of firearms outside of the K9P4P facility.

INITIALS:

Initial Below*

I understand that not every dog will turn out to be a service dog even after many weeks of training. If the dog does not do well with the training or temperament issues begin to arise, the dog will not be able to continue with the program.

INITIALS:

Initial Below*

I understand that if, for any reason, I am unable to keep the dog that has been donated to me by K9 Partners for Patriots, the dog will be returned to the K9 Partners for Patriots program to help another Veteran.

INITIALS:

Initial Below*

I understand that a background check will be done to ensure no charges of domestic violence or animal abuse have been filed.

INITIALS:

Initial Below*

If the Service Animal candidate or it’s associated veteran is removed from the program for any reason, all training equipment as well as the dog will be returned to the K9 Partners for Patriots, Inc. program to be used by a different Service Animal team.

INITIALS:

Enrollment and Documentation*

I understand that enrollment in the K9 Partners for Patriots Service Dog Training Program cannot be completed until I have provided all of the required documentation.

INITIALS:

Use of Images Consent

I give my permission to K9 Partners for Patriots, Inc. to use my picture for their website, Facebook and other program advertisements.*

Yes

Upload Your Documentation

Please upload the following documents :

a copy of DD214
Medical Release Form

(IF APPLICABLE) Name change documentation - marriage, divorce, name change affidavit.

File*

Drop files here or

Accepted file types: acceptedfiletypes:jpg, png, pdf, Max. file size: 2 GB.

If you are requesting that K9 Partners for Patriots provide your dog, you must upload a home walk-through video as part of your application.

Your video must show:

The inside of your home
The front yard
The back yard
Any areas where the dog will regularly live, sleep, or spend time

Please use the button below to securely upload your video through Dropbox.

UPLOAD VIDEO

You do not need a Dropbox account to upload your video.

Upload Instructions
1. Click the upload button below.
2. Select your video file.
3. Enter your name and email address.
4. Click Upload.

Once the upload is complete, you will see “Finished Uploading.” Close the Dropbox window and continue your application.

Tell Us About Your Dog

If you don't have a dog yet, skip this section.

Dog's Name

Breed

Sex

Male

Female

Spayed / Neutered

Spayed

Neutered

Dogs Age

Name of Veterinarian

Agreement to Hold Harmless

I hereby understand that attendance of dog obedience classes is not without risk to myself, members of my family, guests who may attend, or my dog because some of the dogs to which I will be exposed may be difficult to control and may be the cause of injury even when handled with the greatest amount of care.

I hereby release K9 Partners for Patriots, Inc., hereinafter referred to as the “Training Organization”, and any other employees, officers, members, and agents from any liability of any nature for injury or damage which I or my dog may suffer, including, but without limitation, any injury or damage resulting from the action of any dog, and I expressly assume the risk of such damage or injury while attending any session, or any other function of the Training Organization or while on the training grounds or surround area thereto.

In consideration of any as inducement to the acceptance of my application for training membership by this Training Organization, I hereby agree to indemnify and hold harmless this Training Organization and its employees from any and all claims, or claims by any member of any family or any person accompanying me to any training session or function of the Training Organization, or while on the grounds or surrounding area thereto as a result of any action by any dog, including my own.

If the Service Animal candidate is removed from the program for any reason, all training equipment will be returned to the K9 Partners for Patriots program to be used by a different Service Animal team.

Signature*

Date*

Release of Liability

I,*

understand that any dog offered to me as a potential service dog candidate has been fully evaluated by the K9 Partners for Patriots trainer for sound temperament and behavior, to the best of their ability. I realize that some dogs are from rescue situations and there is no way to know their history or background. I hereby release K9 Partners for Patriots, hereinafter referred to as the “Training Organization” and any other employees, officers, members and agents from any liability of any nature for injury or damage which I or my dog may incur. I hereby agree to indemnify and hold harmless this Training Organization and its employees from any and all claims, or claims by any member of my family, as a result of any action by this dog. If the Service Animal candidate is removed from the program for any reason, all training equipment will be returned to the K9 Partners for Patriots program for use by another Service Animal team.

Signature*

Date*

Summary of Notice. This Notice Describes How Health Related Information About You May Be Used and Disclosed and How You Can Get Access To This Information. Please Review it Carefully. K9 PARTNERS FOR PATRIOTS, INC. keeps health-related information about you. This information is personal and private. We need to use this information in many ways. First, we use the information when we treat you or refer you for treatment. Second, we use this information for our health care operations and quality assurance. Under the law, each client has certain rights to the medical information kept by K9 PARTNERS FOR PATRIOTS, INC. These rights are: Access. You can request to view your medical information. Restriction. You can ask to limit who has access to your medical information. You can ask to limit what information is sent out of K9 PARTNERS FOR PATRIOTS Accounting. You can request to review the list of places where your medical information has been sent. Amending. You can request that changes be made to your medical information if you feel that there are inaccuracies. A complete notice with explanations of uses, disclosures, rights and information on how to file a privacy complaint is available at your request. A client also has the right to file a complaint regarding the privacy of their medical information with the Secretary of Health and Human Services toll-free at 1-877-696-6775. Florida Statutes grant clients the right of access to health-related records maintained by health care practitioners. The disclosure of client information by providers is generally prohibited without the client's consent, subject to specified exceptions. Florida also has numerous laws protecting the confidentiality of health information held by a variety of entities and government agencies.

Client Signature*

Date*

Service Dog Training Application

Before You Begin

The following forms must be completed before you submit your application.

Qualifying Criteria

Active Duty or Veteran of the United States Armed Forces

Honorable Discharge

Diagnosis of PTSD, TBI, or MST

Begin Application

Application Spans Multiple Pages

Name Change

Begin

QUALIFICATION REQUIREMENTS

Honorable Discharge Only

Thank you for your service to our country and thank you for your interest in our program.

Felony Convictions are Ineligible.

Defendant in an Ongoing Court Case

PROOF OF SERVICE RELATED PTSD, TBI, and/or MST

NAME & ADDRESS INFORMATION

CONTACT INFORMATION

EMERGENCY CONTACT INFORMATION

PERSONAL INFORMATION

MILITARY SERVICE

K9 Acquisition

A Service Dog is a Big Responsibility

Terms of Use Agreement

Use of Images Consent

Upload Your Documentation

Tell Us About Your Dog

Agreement to Hold Harmless

Release of Liability

No Veteran Should Have to Walk Through Healing Alone.