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We are happy to provide you with the full application for our Client Certification Program. Based on your pre-application, we feel that you may be a good fit for this program, and we would love to learn more about you!
Our goal is to help as many people who would benefit from a service dog as possible. Please be aware that we are, however, currently limited in how many people we can take on as clients. Based on your current needs, as well as our availability for support, you may be put on a waitlist. If that is the case, we will try to help you find external support until things are ready for you to enter our program and become an Atlas client.
Our network of trainers and Team Facilitators is constantly growing, and we hope to keep increasing the number of people we can help.
All information you provide is confidential and secured with very limited access to only the Atlas staff directly involved in supporting you as a client.
Please request an Additional Handler Form and/or Additional Dog Form as applicable from info@atlasdog.org and submit it with your application. Each client wishing to certify should complete this application and process in full.
Please contact us at info@atlasdog.org if you prefer a version of this application that you can print and fill in offline.
You will need to submit four additional items to complete your application. Please find links and instructions to these forms at the bottom of this page. You will be able to upload them on the final page of the application.
Our Ready for Service handout to see if your dog has the foundation needed to enter our program.
A Letter of Medical Indication from your medical provider attesting to your need and that a dog would help mitigate your symptoms. A sample is included here.
An Atlas Veterinary Health Form attesting to your dog's suitability for service work, including current vaccination and health records.
Video submission instructions for demonstrating how your dog acts around other dogs, walking around people, and your dog's comfort level with body handling.
Your Canine Good Citizen (CGC) certificate demonstrating that your dog has passed their CGC.
This information should be completed pertaining to the primary person for whom the dog is mitigating a disability (i.e. the Client). If there is a single handler in addition to the client, their information should also be included in this application. If multiple non-client handlers will be certified, please request and complete an Additional Handler Form for each handler. If multiple dogs are to be certified, please request and complete an Additional Dog Form for each dog. Please submit these documents with your application, as applicable. If the dog will serve multiple clients, each client should complete their own application and provide their own Letter of Medical Indication. Only one copy of the dog’s veterinary and health information is required.
This section is meant to help us understand what your daily life is like, your likes, desires, and how your service dog might be able to help you thrive.
Please explain a typical week in your life. Do you work, go to school, have regular hobbies or activities, etc.? Help us understand how much you are at home vs. out in different settings.
Are there activities you wish to do more of, either in the home or outside? Please describe.
Do you or your household have frequent guests?
Are there activities you would not want your dog to attend to?
Note: If you are requesting certification for a second dog, please request and complete an Additional Dog Form for the extra dog.
Will the dog ever be tied outside?
Where will the dog sleep at night?
What areas of the house will the dog have access to?
Where will the dog go if applicant goes on vacation?
List the types, breeds, and ages of any other pets in the applicant’s home:
I understand that Atlas reserves the right to notify humane animal control or law enforcement authorities if we feel your dog is in dangerous or abusive situation.
What have been your primary source(s) of dog training knowledge?
Briefly describe your dog's current level of training (if there have been no significant changes since filling out your pre-application, mark "no change").
What has been your history with dogs during your life?
What training methods do you prefer to use with your dog?
What do you like to do to let them know they did what you want?
What do you like to do if they do something you don't want?
In the time since you filled out the pre-application, have you worked on any additional general, public access, or disability skills?
Please describe what general skills you have been working on, what progress you have been making, and any challenges you have encountered.
Please describe what public access skills you have been working on, what progress you have been making, and any challenges you have encountered.
Please describe what disability tasks you have been working on, what progress you have been making, and any challenges you have encountered.
Physically:
Emotionally:
Has the applicant or guardian ever surrendered, sold, or transferred ownership of a pet?
If yes, please explain below
List any reasons why the applicant, handler, guardian, or household member would ever surrender, sell, or transfer ownership of a pet.
Has the applicant, secondary applicant, handler, guardian, or household member ever been convicted of a crime?
If yes, please explain. Please note: Convictions do not necessarily prevent eligibility.
Does the applicant, guardian, or household member have pending criminal charges?
If yes, please explain.
All set? Please do a final review of your application and this document. We look forward to receiving your application.
Our Application Readiness Checklist to ensure you and your dog are ready to apply.
We will review the application and other required forms for completeness. If information is missing, we will communicate with you to help resolve the issue. When all information is provided and any issues are resolved, we will set up a time to speak with you via video conference.
All information provided in this application is complete and accurate to the best of my knowledge.
I commit to using only positive, ethical training methods with my dog.
I understand that training my own dog to be a service dog is a big commitment and am ready to put in the effort necessary to do so for the duration of the program, which is at least 6-9 months. I also understand my dog will need regular maintenance training and care their entire life, and am committed to do so.
I understand this application does not guarantee I will be accepted as a client and acceptance as a client does not guarantee my dog and I will be certified as a team.
In the case where handlers in addition to clients are involved, I understand everyone must be committed to and involved in the training, and each handler will undergo the final certification test as well as required recertification tests.
I understand that if Atlas determines that I am a good candidate, there is a $25 application/interview fee that I will be invoiced and must pay prior to scheduling the intake interview. No fee will be applied if I am not accepted to move forward with an interview.
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