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Service Dog – Applicant Questionnaire
Service Dog – Applicant Questionnaire
Bob Malouf
2026-04-21T13:37:15+00:00
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Applicant Name
First
Last
Email Address
Phone Number
on plane, some
Mailing Address
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Would you prefer a Male or Female dog?
How would you describe your level of activity during the day:
Would you be interested/able to participate in sports or other activities with your dog?
Yes
No
What are some expectations you have for your service dog?
Do you plan on traveling via plane, train or bus in the next 12 months?
Yes
No
What public spaces do you visit frequently?
Please tell us what you need from a trained dog and what temperament suits your lifestyle the best:
Submit Questionnaire
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