COUNSELING & MEDICAL ASSOCIATES
Service Dog Agreement
I acknowledge that my completion of this form is to voluntarily register my Service Dog into Counseling & Medical Associates Dog’s registry. Doing so will provide me with identification materials to help others identify my Service Dog. Furthermore, I certify that my Service Dog has been trained to assist me with my disability. I am not registering for fraudulent misrepresentation of a Service Animal, and understand that my dog must meet the legal requirements in order for this registration and identification materials to be valid and to receive the privileges, including access into housing and public places with a Service Animal. Additionally, I understand that both federal and local laws regarding Service Dogs are subject to change in the future, and I will continue to abide by all current regulations. I am aware that as of December 2019, additional documentation may be needed as many airlines now require the signature of a licensed Mental Health Professional on airline specific forms to be submitted in advance in order to travel with my dog. Should any access or privilege issues arise, I hold Counseling & Medical Associates and its agents harmless, and understand That the company Counseling & Medical Associates can provide no guarantees that landlords or any other third parties will be compliant and non discriminatory with access and privileges protected by laws regarding services animals.
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