Veteran Change of Information Form
Veterans are required to update their contact information with PAD any time there are changes to their address, phone number, or email address that is on file. We also need to be informed of any changes to the mental health care providers and veterinarians. 

If you have any questions or concerns, please email us at info@padmn.org or call us at 218-844-6003.

If you are a PAD Staff member and helping a Veteran update their information, please use the Veteran Interaction Form. 
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Email *
Name: *
Dog's Name: *
New Street Address: *
City, State and Zip code: *
Phone Number: *
Alternate Phone Number:
Optional - Complete this section if you have a second phone number (work, landline, etc.).
Emergency Contact Name:
Optional - complete this section if there are changes to your emergency contact information.
Emergency Contact Address:
Optional - complete this section if there are changes to your emergency contact information.
Emergency Contact Phone Number:
Optional - complete this section if there are changes to your emergency contact information.
Mental Health Care Provider Name and Phone Number: *
Veterinarian Name and Phone Number:
I understand that this information will be added to my file at Patriot Assistance Dogs (PAD), and may be used to contact me for PAD communications. By entering my name on this form, I give PAD the right to contact me. I understand that information will remain within the PAD organization, and will not be shared with outside agencies. 

Please type your full name.
 *
Date of Change: *
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