Diabetic Alert Dog Questionnaire

To apply for a Diabetic Alert Dog (DAD) from Thistle Ridge Terriers, please complete the following questionnaire.

Is this dog for you or a family member?*  
Do you have pets in your home?*  
For dogs and cats, please provide their age
and whether they are spay/neutered:

Have you owned a service dog before?*  
WIll your dog accompany you to work or school?*  
Please describe where you live
(Check all that apply):

What are the ages/relationships to you
of the people you live with?
Do any of these people have disabling medical
conditions including Type 1 or 2 diabetics?*
Is anyone allergic to dogs in your household?*  
Does anyone in your household smoke?*  
Have you discussed getting a Diabetic Alert Dog
with your medical advisor?*