Application for a D4D Medical Alert Dog

Dogs4Diabetics is currently placing dogs with diabetics in California, Washington, Oregon, and Nevada for classes in 2010. In order to qualify, the diabetic must be at least 12 years old and have been diagnosed and on insulin therapy for at least one year.

D4D does not maintain a wait list of applicants--you must be at least 12 years of age and live in the current service area for your application to be accepted. If you do not yet qualify, please continue to check this site for updates, as D4D is expanding as funding allows.

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Phone 1
Phone 2
How did you hear about D4D?	*
Tell us a little about your diabetes and how you manage it.	*
Briefly describe your lifestyle.	*
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