INITIAL APPLICATION - FOR A GOLDEN HEALER SERVICE DOG

This is just the first step of the application. Once this form is submitted a representative from Golden Healer Service Dogs will contact the responsible party within 1-3 weeks for a full evaluation and consultation session and discuss the next steps of the application process. 


APPLICANT INFORMATION

Name *
Name
Address *
Address
Phone *
Phone
Date of Birth *
Date of Birth
RESPONSIBLE PARTY
Parent 1:
Phone 1: *
Phone 1:
Parent 2: *
Parent 2:
Phone 2: *
Phone 2:
Phone:
Phone:
Household Information *
Type of Home:
Do You Own or Rent? *
Do you have a fenced yard? *
If not, do you plan to fence the yard? *
Are there currently pets in the home? *
Species: *
Please specify "other" species in the home:
Can you feed the dog ($25 - $50 of food a month)? *
Can you regularly bathe and groom the dog? *
If not, can you afford to pay for dog grooming? ($30 - $70 3-4 times a year) *

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Get Involved

Would you like to get involved? We need puppy foster homes.