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Please answer the following preliminary questions so that we can verify whether you are eligible for a hearing dog. We will reply to you via email within 5 business days

The complete application requires a copy of your most recent hearing test, a photo of yourself, and a blueprint or drawing and photos of the residence where the dog will live.

Your Contact Information
First Name
Last Name
Initial Application Questions
1. Are you planning on moving to another residence within the next year?
7. Is your boss aware that you will bring a Hearing Dog to work?
11. Does the school approve of Hearing Dogs?

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