020 3380 8037
    07961 518661
info@autismlifedogs.com

Changing Lives -
one paw at a time

Apply for a dog

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Please complete the application enquiry form below as fully and accurately as possible to enable us to best assess your needs. We recommend you read our FAQs and check our eligibility criteria before applying. Once we receive your form one of the team will be in touch to discuss your application in more detail.

Family Details


Child's Details


Health

Sensory Processing

Behaviour, Interests & Education


Family Life


Housing Information


Lifestyle

Please, describe the child’s typical daily schedules and activities. This information will give us some insight into what they do, how they spend their time and environments into which they regularly go.


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