NEADS  NEADS Service Dog Application 

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Applicant Information














NEADS dogs are typically Labrador retrievers. Please visit www.assistancedogsinternational.org (ADI) to help you find an organization that can meet your needs. 




Due to requirements for our grants and other funding mechanisms, we are unable to serve veterans with any discharge types other than Honorable and General Under Honorable Conditions.

For information about Discharge Upgrades, please visit the VA website.
Service Details
Answers to the following questions about your service can be found on your DD214.






Employment and Activities



Employment details










Please note: NEADS will require a letter from your employer stating that you are able to bring a Service Dog to work. NEADS will provide details about what's required during the application review process.

Volunteer Activities


Please note: NEADS may ask for a letter from the volunteer organization stating that you are able to bring a Service Dog to volunteer. This will be determined during the interview process.

For Students








Please note: NEADS will require a letter from your school stating that you are able to bring a Service Dog to school with you. NEADS will provide details about what's required during the application review process.
Physician & Emergency Contact Information
Physician Information
Please note: If you are invited to interview for our program, we will provide you with a medical report that needs to be completed by your primary care physician. 






Emergency Contact Information
Who can we contact in the event of an emergency?






Who will help you with the dog's care if you are sick or cannot get outside?






Service Dog applicant - medical information
When describing your medical history, please do not use abbreviations or initials for diagnoses or conditions that are atypical or rare. Commonly used abbreviations such as SCI, MS, ADHD, EDS and POTS are fine.


Use of Assistive Devices












Personal Care Needs



*Please NOTE: NEADS does not provide personal care attendants and no staff member is trained as a PCA. Part of the interview and evaluation process will be determining who will provide care while you are on the NEADS campus for training if you are accepted for a match.
How will a Service Dog help you?
All NEADS dogs are taught basic dog obedience and socialized in public situations. 
What tasks do you want your dog to help you with?
NOTE: NEADS dogs can help with stationary balance for a short time but do not help with balance while walking.




Home Environment



Apartment Details





Yard details




Rental details
If you are renting, please fill details below.




If you are accepted to the NEADS program, we will need to have written permission for you to have a Service Dog in your home.


Please note: NEADS will require a letter from all adults in your immediate household stating that they are aware that a Service Dog may be placed with the applicant and understand the implications for the household. NEADS will provide details about what's required during the application review process.
Lifestyle












Hold the shift key to select multiple options.

Current Dog and Other Pet Information



Dog Ownership History








Caring for your Future Service Dog
NEADS Service Dogs are with their partners 24/7. NEADS clients are responsible for providing appropriate care and exercise and a healthy, safe environment for their Service Dog. Please answer the following questions to help us understand the environment you will provide for your Service Dog should you be accepted into the NEADS program.





Service Dog Training
All clients are trained with their dogs at the NEADS campus in Princeton, MA.

We're sorry, but we are unable to proceed with your application. Training at the NEADS campus is integral to the success of our Service Dog teams and a required part of our program. You can read more about our client training here. 
If accepted for a Service Dog, when the right dog has been selected, we typically provide 4 weeks notice prior to training.

Thank you for your application. Please click SUBMIT to proceed to the final step, which will take you to a signature verification page. You must sign at the bottom of this page and click the 'Submit Signed Response' button to complete your signed response.

You will receive two emails:
The first is an email asking you to verify your signature. You must click on the link in that application to verify and ensure that your application is received.

You will also receive an automatic email confirming our receipt of your application. NEADS staff will review your application and be in touch with you within 8 weeks.

Thank you,

the NEADS Client Services Team

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