Use this form to securely submit supporting documentation and medical information requested by our team.
Information submitted through this form is secure and confidential. Your doctor or other medical professional may also use this form to submit information on your behalf.
Please submit any supporting documentation, prescription for a Service Dog, or other requested information by our team here. Information submitted is encrypted and secure. More information can be found in our privacy policy and confidentiality waiver. If you have any questions, please direct them to the current client support director, Dr. Kylie Goodyear, CCFP(EM) (kylie.goodyear@k9pad.org)
Your information will be encrypted.
Registered Charity 765390299RC0001
Your browser does not support capabilities required for electronic signatures.
Click a signature you want to use: