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Service Dog ID Card
Order Number *
Dog's Name *
Breed of Dog *
Height of Dog
(Measure from center of back to floor)
(example: 22 inches) *
Weight of Dog *
Microchip number, if any
AKC or UKC number, if any
Owner's Name *
Owner's Address *
Owner's Telephone/TTY/VCO Number *
Owner's E-Mail Address *
Offer proof of need:
How does your dog help you?
How does your dog alert you?
Please call for interview - 480-837-0190 or Toll Free 866-913-HEAR (4327)
*
I grant permission to use my photo in the Photo Gallery on the website. *
You have reached the form to order a Service Dog ID Card from www.hearingimpaired.net
Please don't forget to return to our shopping cart to purchase this item.
And don't forget to submit a photo of you and your dog.
Thank you.
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