Vets With Pets Application

Name*

Branch of Service*

Email*

Phone Number*

Address*

Are you able to have a dog at your residence?*

Yes

No

Other

Do you have the financial means to care for a dog?*

Yes

No

Other

What benefit do you feel you would get from having a dog?*

What conditions do you have as a result of military service?*

Chronic Pain

Long-Term Physical Injury

Mental Health

Other

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