Service Dog Application

APPLICATION

PAWSable.Life and Paws 4 Autism Service Dogs

Considering a service dog to assist your needs can be daunting. We want to help you through that process! We will help you decide whether it is a good choice for your family and challenges, then help you choose an agency that best fits those needs. Sometimes we are the right fit....sometimes another agency. We have several specialists that we refer to when needed. Currently, we our focus is on working with families in the Kansas City region. However, we will consider and consult on a case by case basis with families outside the KC Metro.

First step is our basic online application:

* Indicates required field

Client Name *

Client Age *

Primary Email Address *

Primary Caregiver (if minor applicant) *

First

Last

Secondary Caregiver (if minor applicant) *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Pets: Please note if Past or Present *

What is the approximate square footage of your residence? # of bedrooms? Yard Size? Fenced? *

Family Members (Name/age/relationship) *

Do you vacation as a family? What does your family do for recreation? *

Does the client attend school? What District? If no, Why not? *

Occupation/s of Primary/Secondary Caregiver *

Can you afford an average of $250 per month (shots/hygene/food etc) to support a service dog? *

Yes No Will need to get creative

Where will the service dog sleep? Where will they rest? *

Where/When/how often will you exercise the service dog? *

What are the major challenges you experience? How do you hope that a service dog will help? *

What are your expectations for a service dog? *

Is there anything we have not asked that you feel is important for us to know about? *

ACKNOWLEDGEMENT OF TERMS AND CONDITIONS OF SERVICE DOG PLACEMENT *

Primary Caregiver Secondary Caregiver Recipient Child

Should our application be accepted into the PAWS program, we, the undersigned, will be required to demonstrate aptitude, competency, and a commitment to follow PAWS education, standards and training. The undersigned agree that if any of the standards of veterinary care, health, grooming, cleanliness, and housing are not met, or if the dog is repeatedly placed in danger or is receiving negligent care and/or treatment, PAWS has the absolute unequivocal right to permanently remove the dog from our possession with or without notice. The undersigned agree that in this case no compensation and/or refund of the sponsor's or recipient's contribution or associated placement costs will be returned.

We understand that contributions are not payment for a service dog, nor a guarantee our child will receive a service dog. While contributions may be given to PAWS on behalf of a particular child, we understand those funds do not constitute a purchase. After we, the primary and secondary caregiver, have successfully completed PAWS fundraising requirements, educational training and made the required preparations to receive the service dog, PAWS dog placement will proceed with the recipient child and his or her family. On average, service dogs are placed with each family 18-24 months after fundraising is completed. For those participating in the puppy partners program this timeframe is significantly less.

If at any time during the fundraising process, during team training, the two week transitional phase or the week of tether training, an PAWS representative determines the caregiver, caregiver's partner or family is unsuitable to continue placement of a (service) dog, PAWS may exercise its right as stated above to withdraw the service dog without monetary reimbursement to any party.

SUBMIT APPLICATION

After we review your initial application, we will schedule a phone interview to go over your application and answer any questions you may have. If both parties agree to proceed, then your application is sent to our Board for preliminary approval and an in home meeting will be scheduled.

During the in home meeting we will discuss the process in detail and do an initial evaluation of the client with one of our service dogs in training. If both parties agree, then a home study will be scheduled. The home study consist of a minimum of three in home visits by Lennis Marvel, LCMSW. Mrs. Marvel has detailed psychotherapy experience working with both youth on the spectrum as well as with autism service dogs and serves as an adviser to the Paws Board of Directors. You will receive a complete copy of the home study that will be sent to our Board for final approval into the program. Cost is $500 and is included in the total amount needed for fundraising.

Families in our program are provided a fundraising page where they can share photos and tell their story. We do everything in our power to help our families with their fundraising efforts. Assistance can include business cards for sharing with other to direct them to your fundraising page, banner use for activities (lemonade stands/garage sales/ movie nights/etc.), team fundraising at PAWS events (Funds that your team raises for our events are credited towards your goal), and sharing on our social media pages. Also, any sponsors that you secure for Paws are credited towards your goal.

We do request our families to raise an average of $500 per month to maintain their position in the program. Families may choose to withdraw at any time, however funds raised for the program will not be refunded.