Client Application Request

The PAWS client application request form is closed for 2026 and will reopen in January 2027.

How it Works

PAWS has an annual open application request period for first-time applicants from January to March. During this time, you can complete our client application request form for a non-refundable $50 fee that covers the cost of processing applications.

This form is not a full assistance dog application. Before submitting the application request form, please review the types of assistance dogs we offer as well as the qualifications for each, and verify that we service your area by checking our service map.

After submitting the form, our client services team will review your request to ensure that you meet our baseline client qualifications. If your application request is accepted, you will receive the full application via email. If PAWS is unable to meet your needs, you will be notified, and our team will share other assistance dog programs that may be better suited for you.

If you currently have or have had a PAWS assistance dog and would like to apply for a successor dog, please contact PAWS directly by calling (616) 877-7297 or emailing us at csdirect@pawswithacause.org.

Please be aware that in order for PAWS to place an assistance dog with you, we must have a local field representative in your area, and that coverage is subject to change at any time.

PAWS Service Map

Client Application Form

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This field is for validation purposes and should be left unchanged.

Applicant Information

Applicant Name(Required)

First Last

Applicant Cell Phone(Required)

Applicant Home Phone(Required)

Applicant Email(Required)

Applicant Date of Birth(Required)

MM slash DD slash YYYY

Are you a representative filling this application request out on behalf of the applicant?(Required)

Yes

Representative's Name

First Last

This field is hidden when viewing the form

Representative's Name

Please provide first and last.

Representative's Phone Number

If different than applicant's phone number.

Representative's Email

If different than applicant's email.

Is the applicant aware you are requesting an application on their behalf?

Yes

I'm requesting an application for a Service Dog for a Child with Autism.

What is your relationship to the applicant?

Why is the applicant not completing the request themselves?

Write N/A if you are completing a request for a Service Dog for a Child with Autism.

Are you (applicant) a veteran?(Required)

Yes

Is someone in your immediate family a veteran? (Please check all that apply.)

Spouse / Significant Other

Parent

Child

How did you hear about Paws With A Cause?(Required)

Applicant Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please understand that due to the increased demand for assistance dogs nationwide, the demand far outweighs the supply. Not everyone that applies will be able to receive a PAWS assistance dog. The $50 application fee is nonrefundable.

I acknowledge that I have checked the field representative coverage map and live in one of the covered areas.(Required)

Click here to review our field representative coverage map if you have not already done so.

Yes

I acknowledge that I have read the Applicant FAQs and application process.(Required)

Click here to review our Applicant FAQS if you have not already done so.

Yes

I acknowledge that my disability has been diagnosed by a medical professional at least one year prior to submitting my application to PAWS.(Required)

Yes

I acknowledge that everyone 18 years of age and older living in my household will undergo a background screening.(Required)

Yes

What would you like an assistance dog to do for you?(Required)

Please list any cognitive disabilities (i.e. Down Syndrome, short/long term memory loss, dementia, dyslexia, Attention Deficit Disorder and other learning disabilities) along with any mental health diagnosis, or enter "None".(Required)

Your Readiness to Care for an Assistance Dog

Please answer the following questions regarding your ability to provide and care for an assistance dog, which may weigh as much as 90 lbs.

Are you able to afford a minimum of $1,600-2,000 a year for the upkeep and care of your PAWS dog?(Required)

Yes

If no, please provide the name and phone number of the person who has agreed to assist you financially with the upkeep and care of the dog:(Required)

Are you able to provide daily exercise for your assistance dog?(Required)

Yes

If no, please explain:(Required)

Are you able to take your assistance dog out multiple times throughout the day for bathroom breaks?(Required)

Yes

If no, please explain:(Required)

Are you able to have your assistance dog bathed and groomed every three months?(Required)

Yes

If no, please explain:(Required)

Are you able to practice and physically train with your assistance dog on a daily basis?(Required)

Yes

If no, please explain:(Required)

Do you have a support system of at least two non-household members, that can care for your dog, should you become hospitalized or unable to do so?(Required)

Yes

Home Placement & Other Dogs Policy

A PAWS assistance dog will not be placed in a home with any other dog, unless it is a retired PAWS dog or working assistance dog from an assistance dogs International or International Guide Dog Federation-accredited agency for someone else in the household. It has been our experience that other dogs in the home can interfere with the bonding and training process of the assistance dog team.

Is the applicant allergic to dogs?(Required)

Yes

What level of reaction do they have?(Required)

What are the signs or symptoms?

Is anyone in the household allergic to dogs?(Required)

Yes

What level of reaction do they have?(Required)

What are the signs or symptoms?

How will you address the allergies if a dog is placed in the home?(Required)

Do you need a hypoallergenic dog?(Required)

If yes, medical proof will be required.

Yes

If yes, please explain:(Required)

Assistance Dog Needs & Details

What type of assistance dog are you applying for?(Required)

I acknowledge that I was born before March 31, 2009.(Required)

Yes

Hearing Loss: Please list all diagnosed disabilities and date of diagnosis.(Required)

Hearing Loss: Which type of hearing loss have you been diagnosed with?(Required)

Bilateral

Unilateral

Hearing Loss: What tasks or skills would you like a hearing dog to do for you?(Required)

Hearing Loss: Please provide the month and year the diagnosis was made.(Required)

Diagnosis must have been made a minimum of one year before submitting this form.

Hearing Loss: Which sounds do you need a hearing dog to alert you to?(Required)

Hearing Loss: Do you have a preference for dog size?(Required)

Small

Large

No Preference

I acknowledge I was born before March 31, 2013.(Required)

Yes

Physical Disabilities: What is the primary disability for which you are applying for a service dog?(Required)

Please only list the primary disability for which you are applying for a service dog.

Physical Disabilities: Please provide the month and year the diagnosis was made.(Required)

Diagnosis must have been made a minimum of one year before submitting this form.

Physical Disabilities: List all other disabilities, including mental health diagnosis.(Required)

Physical Disabilities: When was each diagnosed?(Required)

Mental Health Diagnosis (if any): When was each diagnosed?

Physical Disabilities: What tasks or skills would you like a service dog to do for you?(Required)

Seizures: Have you been diagnosed with epileptic seizures?(Required)

Yes

Seizures: Please provide the month and year the diagnosis was made.(Required)

Diagnosis must have been made a minimum of one year before submitting this form.

Seizures: I understand that a PAWS epileptic seizure response dog does NOT predict seizures.(Required)

Yes

Seizures: I understand that a PAWS epileptic seizure response dog will NOT provide protection.(Required)

Yes

Seizures: I understand that a PAWS epileptic seizure response dog will NOT guide me to safety.(Required)

Yes

Seizures: I understand that a PAWS epileptic seizure response dog will NOT roll me over.(Required)

Yes

Seizures: Please tell us how often your seizures occur.(Required)

Seizures: What types of seizures do you have? (grand mal, petit mal, partial-complex, cluster, absence, etc.)(Required)

Seizures: What is the frequency of each type of your seizure (daily, weekly, monthly, etc.)?(Required)

Seizures: What tasks or skills would you like a seizure dog to do for you?(Required)

Autism: Has your child been diagnosed with Autism?(Required)

Yes

Autism: Please provide the month and year the diagnosis was made.(Required)

Autism: Children must be born after March 31, 2019, to be eligible for a PAWS service dog for a child with autism. Was your child born after March 31, 2019? (Required)

Yes, my child was born after March 31, 2019.

No, my child was not born after March 31, 2019, and therefore we do not meet the eligibility requirements.

Autism: My child exhibits (check all that apply):(Required)

Meltdowns at home

Meltdowns at school

Meltdowns in public

Kicking, hitting, pinching, or biting

Wandering

Fixation on specific objects

Bolting

Not sleeping well

Self-stimulation

Anxiety or fears of places or objects

Autism: My child also exhibits...(Required)

Autism: My child is currently in (check all that apply):(Required)

An ongoing education program

Physical therapy

Speech therapy

Occupational therapy

Recreational therapy

Other

If other, please describe.

Autism: Do both parents live in the same home? If not, will both parents be facilitators for the placement?(Required)

Autism: Please list all of the addresses where the child will reside.(Required)

Autism: Please describe the effects of autism on the child and the family.(Required)

Autism: What tasks would you like an assistance dog to do for your child?(Required)

Medical Alert: Do you have type 1 diabetes?(Required)

Yes

Medical Alert: Do you have POTS?(Required)

Yes

Medical Alert: Please provide the month and year the diagnosis was made.(Required)

Diagnosis must have been made a minimum of one year before submitting this form.

Medical Alert: How often do you experience diabetic lows/POTS episodes?(Required)

Medical Alert: What tasks or skills would you like a medical alert dog to do for you?(Required)

Application Fee & Payment

I acknowledge that I have reviewed PAWS' service area map and that I live within it.(Required)

Click here to view PAWS' service area map.

Yes

I acknowledge that my $50 application request fee is non-refundable.(Required)

Yes

Client Application Request Fee(Required)

Price:

Total

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