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Applicant Eligibility Survey

If you do not live within 50 miles or approximately one hour’s travel time of Hero Dogs (zip code 20833), do NOT complete this form (see mandatory eligibility requirements).

No
Yes
Service Dog
Skilled Home Companion Dog (no public access)
Veteran of U.S. Uniformed Services
First responder
Military or first responder immediate family
Other
Physical disability
Balance or mobility
Hearing loss
PTSD or psychiatric disability
Other
Medication monitoring
Individual psychotherapy
Group counseling
Not currently receiving mental health services

Please scan and email a copy of your most recent DD Form 214 (Member - 4 copy) to applicant@hero-dogs.org. If you are a first responder, we will contact you to provide verification of service eligibility.

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