APPLY FOR A SERVICE DOG

PTSD SERVICE DOGS TRAINED JUST FOR ABUSE SURVIVORS

dogs trained, paired, and gifted to Survivors for no cost

trained special for one person, with their needs in mind

wholistic and somatic approach to
PTSD recovery

long-term advocacy and support for Survivors on their jounry

Requirements

01.

That you be 18yrs old or older

02.

That you have a formal PTSD diagnosis

03.

That you be working with a therapist*

04.

That you can care for a Service Dog

05.

That you live in the United States

*Or have worked with a therapist within the last 3mo, where they would be willing to participate in the application process

Steps

Fill out your portion of the application

You won't want to fill this out on your phone. Try to find a quiet place, and plan to take about 2hrs to go through all the questions, and answer appropriately.

Receive your follow-up emails

Once your submit your application, you will recieve two follow-up emails. One to send to your theraipst (or past therapist), and one to send to a close friend.

Forward BOTH of your follow-up emails

Make sure you send these to the appropriate email addresses!! These are required for your application to be accepted.

Make sure all parts are completed within a month

Once you submit your application, you have one month to make sure all pieces are completed. If you run out of time, you can resubmit your application to re-start the clock, but you won't be getting your application fee back =(

SURVIVOR'S PORTION

note: there is a $25 application fee to get started

Remember: your application won't be completed until all 3 pieces are submitted. Scroll up to "Steps" if you need a refresher on how to proceed.

First name

Last name

Where do you live?

How long (approximately) have you lived here?

Approximately, when did you receive your PTSD diagnosis?

I don't have a PTSD diagnosis

Regardless of formal diagnoses, how long have you been experiencing the symptoms of PTSD?

What symptoms would you say impacts your life the most? Please list by order of severity:

If you feel like you need to explain any of this, please add an explanation here:

Can you briefly explain the trauma you experienced? This can include what age you were, duration of trauma, etc. This is NOT to assess the severity of your trauma, but to help us identify what training your potential service dog might need.

If you have any diagnoses other than PTSD, list them here

What methods do you currently use to cope with your trauma?

What treatment methods have you tried? How do you feel about their outcomes?

Do you have any criminal charges? (note: this won't disqualify you, so please be honest)

Yes

How much money would you be able to budget every month for your service animal? Enter dollar amount:

Do you have the financial means to travel to Indianapolis?

Yes

Don't know/Unsure

Do you currently have pets?

Yes

On a scale of 1-10, how connected do you feel to your body on an average day?

On a scale of 1-10, how connected do you feel to your body on an bad day?

Would you say you have a strong support system? Explain here:

Do you ever feel "numb"? If so, how frequently do you experience this? How long does this feeling typically last? Please explain:

How do you typically respond in a crisis? Explain here:

Do you express fear? What does this look like for you? Explain here:

Do you experience sorrow? If so, what does that look like for you? Explain here:

Would you say it’s easy or hard for you to express love to those you care about? Explain here:

Do you experience anger? If so, what does that look like for you? Explain here:

Do you experience joy? If so, what does this look like for you? Explain here:

When someone challenges or criticizes you, how do you respond? Explain here:

How do you respond to change? Explain here:

How often would you say you change your mind? Explain here:

When you make a mistake, how do you typically respond? Explain here:

How do you respond to emotions? Emotions that feel small, and feel big? Explain here:

When you begin to feel overwhelmed, how do you respond? Explain here:

Would you identify as "sensitive"? Why, or why not? Explain here:

Do you experience laughter? If so, when do you most experience it? Explain here: