Apply For Service Dog Group Class and/or Accreditation Program Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Human's Name *FirstLastIf you are applying on behalf of someone else, state your name below:FirstLastDisability from that Have Year of diagnosisAdditional/comorbid medical conditionsIs your condition progressive?YesNoThe doctors have no clueAre you willing to submit a criminal records check? *YesNoCriminal history will not necessarily exclude you BUT we have a zero tolerance policy on sex crimes, domestic abuse, crimes involving children, and cruelty toward animals. Any other criminal history will be considered in context with your past and current situation. What are you applying for today? *I want to join group service dog classesI want to apply for accreditationAre you looking to apply to Heeling Assistants for our help with training your service dog? This is the place to start. Please read all fields carefully. We make our acceptance criteria clear. Your application fee will NOT be refunded if we decline your application. Address *Note: In-person coaching is only available in the Lower Mainland of BC at this time. We can coach online, but you cannot join group classes online!Email *Primary Phone Number (Mobile Phone Preferred) *Alternate Phone NumberCan be phone number of spouse or parent.Do you have the following proof of disability? Check all that apply *Person With Disability provincial statusDisability Tax CreditA Heeling Assistants Medical Recommendation Form filled by a Canadian doctor, psychologist, or psychiatristReport of diagnosis by a Canadian doctor, psychologist or psychiatristXrays, MRI results or other medical imagesOtherEveryone’s situation is unique. We know that sometimes medical diagnosis is difficult to come by. We offer multiple avenues to demonstrate your disability status. If you checked "other" explain below:What jobs/skills related to your disability can your dog already do? *What jobs/skills would you like your dog to learn? *How would having a fully trained service dog change your life? *Do you need your dog to be certified before a particular date? If so, explain.Describe in a few sentences your dog's average daily routine *Has your dog been seen by a vet within the last 12 months? If so, was it a medical visit or routine/vaccination visit?How often do you offer your dog water when you are out together? *As often as my dog asks for itEvery half hour or soAfter an hour or moreHow often does your dog play so hard that they are panting and out of breath? *DailyThree times a weekOnce a weekI don’t understandDoes your dog have another familiar person who looks after them/walks them when you cannot?Dog Name *Dog Type *Breed or most likely mixDog's Age *If your dog is under one year of age, please see our puppy programs.Has your dog been diagnosed with any chronic/ongoing medical problems such as allergies, hip dysplasia, luxating patellas, heart conditions, elevated liver or kidney values, chronic gastrointestinal issues, eye problems, etc? If so, describe. *Note that many dogs can and do work despite problems such as those listed above, however the health and fitness of the dog must always be considered and we need to know about them. NOTE! Failure to tell us about a known medical problem may result in you being expelled from the program even if the condition is not disabling to the dog!Have you taken any of our classes or programs in the past? *Yes, puppy raising programYes, urban group classesYes, both of the aboveNoIf yes, which trainer(s) did you work with?Have you worked with any other trainers? If so, what did you learn from them? *Does your dog have a history of biting humans or dogs out of fear or aggression? *Approximately how long does it take your dog to settle into a relaxed "down" position in a quiet environment such as a public library or quiet cafe if you give your dog no specific instructions or commands? *Less than two minutesLess than five minutesLess than fifteen minutesMore than fifteen minutesWithout prompting, approximately how often does your dog check your face when you are walking outside? *Several times a minuteMaybe once a minute or soRarely unless prompted or lured with a treat.I don't know, I'm not usually watching for itDoes your dog explore new places more eagerly or less eagerly depending on whether or not you or a stranger are with them? *Explores more if I am presentExplores less if I am presentUnknownHas your dog ever fallen asleep in the following locations? Check all that apply. *At a restaurant or coffee shopIn a libraryIn a mallIn a parkIn a carIn a familiar house other than your ownIn a house they have never visited beforeIn a crate or kennelAlone in a room of your houseWhich image best represents how we think dogs see the world? *Similar to HumansGreyscale/no colourBlue/yellow onlyred/yellow onlyWhy are we asking this? Your current understanding of the canine brain and body tells us how much learning you still need. If your dog balks/does not want to do what you ask, how do you respond? *I try to figure out why and do not insist unless it is urgent/life and deathI increase motivation through encouragement and rewardsI enforce it physically so the dog learns that they must respond.What equipment do you typically use to attach a leash to your dog? Check any that apply *I do not usually use a leashElectronic/remote collarMartingale slip on collarSlip collar that contstricts the airway when dog pullsProng collarHead halterFront clip harnessBack clip harnessFlat buckle collarWhy did you choose this equipment? *Do you use a flexi-leash aka retractable leash and if so WHY?Do you feed your dog treats while working? *Yes to keep them engagedYes to reinforce good behaviourNo/sometimes – they don’t like treats muchNo, I expect my dog to obey without themIs your dog spayed/neutered? *YesNot yetNo and I do not plan to do so.Will you ask your vet to email us your dog's records from the past 18 months? *YesNoUnsure/I don’t have a vetIs your dog already certified through a provincial certification program such as the BC Guide Dog and Service Dog Act? *YesNoApplication accepted, test pending.Do you understand that if you live in BC, Alberta or Nova Scotia, you must achieve provincial certification before you can graduate from our program? *YesDo you understand that training must be maintained and continued through the lifetime of the dog, and that service dogs must recertify every two years? *YesThank you for applying. How do you prefer to be contacted? *Voice CallVideo CallSMS Text MessageEmailIf there are any specific accomodations for your disability that you require when we contact you, please explain below:Apply Now
