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Guide Dog Application You can start the guide dog application process online, download a Word version of the application, or request an application packet. If at any point in the process you have questions, please call our Consumer Services Department at (866) 282-8047. Online Application The application contains four sections: Demographics Physical History Travel Skills Guide Dog Information Most of the fields are required. We encourage you to review the form in its entirety before filling it out. This way, you’ll know the type of information we need. All of the required fields must be filled in; if not, the form will not transmit. If the fields contain inadequate or inappropriate responses, it could delay the processing of the application. A link to the online application appears at the end of this section of information. Once our Consumer Services Department has received this completed application, we will contact you. In addition, the Guide Dog Foundation requires three personal references, a reference from your Orientation & Mobility Instructor, an Eye Report from your ophthalmologist and a medical report filled out by your physician. A decision on your application will be made once the Consumer Services Department receives all of these completed forms as well as the references, and after an interview is conducted. Copies of those forms are available here, so you can review them. If you wish to expedite your application, you may download these forms and forward them to the appropriate people now. Completed referrals and reference letters should be sent to: Barrie@guidedog.org or mailed to Consumer Services Department, Guide Dog Foundation for the Blind, 371 East Jericho Turnpike, Smithtown, New York 11787. They also can be faxed to (631) 930-9009. Information Release This form gives the Guide Dog Foundation permission to request information pertinent to your application. You, the applicant, should complete this and forward it to the Foundation. Emergency Contact Form If we are unable to contact you during the application process, or if your contact information changes, we will get in touch with the emergency contact(s) you specify. You, the applicant, should complete this form and forward it to the Guide Dog Foundation. Personal Reference Request Form Forward this form to three people who are not related to you. They should read it, follow its instructions, and forward their information directly to the Consumer Services Department at the above address. (We need to receive it directly from them, not from the applicant.) Agency/O&M Referral Form The Guide Dog Foundation must receive information from the agency/O&M specialist who provided you with your Orientation and Mobility Training. Forward this form to your contact. He/she should read it, follow its instructions, and forward their information to the Consumer Services Department at the above address. (We need to receive it directly from them, not from the applicant.) Ophthalmologist Eye Report The Guide Dog Foundation must receive certain information from your ophthalmologist or eye care specialist. Forward this form to your eye doctor. He/she should read it, follow its instructions, and forward their information to the Consumer Services Department at the above address. (We need to receive it directly from them, not from the applicant.) Medical Form The Guide Dog Foundation must receive certain information from your general practitioner physician. Forward this form to your medical doctor. He/she should read it, follow its instructions, and forward the information to the Consumer Services Department at the above address. (We need to receive it directly from the doctor, not from the applicant.) In addition, if you have been seen by any of these specialists in the past 18 months, they need to complete the medical form and submit it to us as well. Please forward the medical form to your cardiologist, neurologist, endocrinologist, orthopedist, and/or rheumatologist. They should read the form, follow its instructions, and forward the information to the Consumer Services Department at the above address. (We need to receive it directly from the doctor, not from the applicant.) Video To assist us in evaluating your travel skills, and help us better understand your needs, we require a 10 minute home video. Click here for guidelines for the video. Click here to proceed to the online application. Print Application The application form is available here as a Word file. You can download it, complete it and email it to us, or you can print it out, complete all the fields and mail it to us. You can provide your information to us in a number of ways:
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