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U.S. Service Dog Registry Questionnaire

Information on this page will only be available if someone enters your 10 digit code into the United States Service Dog Registry website.

Are you filling out this form for yourself or someone else?

Please register with the information pertaining to the person who uses the Service Dog.

First Name

Last Name

Gender

Address (will be kept private)

City

State

Zip Code

Phone (will be kept private)

TTY/VP

Dog's Name

What year was your Service Dog born?

What breed of dog do you own?

If Mixed Breed/Other Breed Enter Here

Dog's Gender

Upload a picture of you and/or your dog (Optional).

Our privacy policy is simple. The United States Service Dog Registry and the Service Dog Census Project WILL NOT share your personal information with another organization. Ever. Period.

Your profile is only available by entering your 10 digit code or first name, last name and dog's name. This serves to confirm your registration status.

When someone looks up your profile they will see your name, dog's name, and optional photo. No other information is accessible.

We will never ask for your password, username or credit card or other information in an e-mail.