Paws for Life Client Application Video Outline Part C

Please provide a 10-15 minute video and submit with Part A of your application. Your video is critical. Paws for Life USA reviews it frequently during the placement process:

-Initially, to see IF we can have the right dog for your needs and accept you as a client.

-When matching teams, to evaluate whether a dog in training fits your lifestyle and your needs.

-During custom-training of the dog to meet your needs.

Describe yourself:

Name and address. Tell us about your family, friends, and personal attendants. Tell us about your pets (past and present). Describe

your daily routine – work, school, and other activities.

Describe your disability – Tell us about:

The history of your disability. Your accomplishments. Your limitations. Your activity level. Your daily routine.

Demonstrate your mobility level:

Show us how you move around inside your home and workplace or school. Show us how you use your adaptive equipment.

Show us how you transfer. Show us your mode of transportation outside your home

Describe what your dog would do: How do you think a dog will be able to help you? What skills would you need? What are your expectations of an assistance dog? Do you currently have or have you ever had a service dog? If so: a. Where did you get your service dog (organization, private trainer, self-trained, other)? b. How many years did the dog work with you? c. If you still have the dog, show your service dog interacting with you.

Show your environment: Home – Video the interior and exterior of your home, your yard (including any fencing), and your neighborhood (where you might walk with your dog) Show your interaction with any present pets you may have. Other – Video your work, school, recreational and/or social environment.

Instructions

Please list the name and contact information of two people who will provide letters of recommendation for you:

1) Personal (not a relative), 2) Professional (therapist, doctor).

Please send letters of recommendation to: Paws For Life USA P.O. Box 72016 Marietta GA 30007-2016 Fax 770-579-8289 admin@pawsforlifeusa.org