MD Dogs Birdi - Application
Welcome to MD Dogs' Diabetic Alert Dog Application. Our priority is to find an individual who will be the best match for each dog on all aspects such as activity, lifestyle,  career, etc. Below are the steps that are required to be matched with an MD Dogs Diabetic Alert Dog:
1) This application
2) Online class (this will be emailed to you)
3) Zoom calls - with the founder, Libby & with a Board Member
4) In person meeting
5) Home visit

If you have any questions about this application or the process, feel free to contact us at mddogsinc@gmail.com. We look forward to reading your application!
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First Name of applicant *
Last Name of applicant *
Parent or guardian name (if applicant is a minor)
Email address *
Which condition affects the applicant? *
Please list the any additional medical conditions the applicant has. (e.g. Anxiety, celiac disease, thyroid disease. This is critical because some conditions affect the dogs' abilities to alert.) *
To confirm, you are interested in applying for Birdi? *
Would you like the dog to be trained for any other disability related tasks as well (allergen detection, hearing alert, etc.)?
Are you looking for an in-home only Diabetic Alert Dog or one who will accompany the applicant in public places?
Phone number *
Home street address *
City *
State *
Zip code
Would you be willing and able to travel to Lexington KY for up to 1 week of transition training? (This is required) *
Applicant's birthdate *
MM
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DD
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YYYY
Date of diagnosis (or approximate) *
Date of last a1c *
MM
/
DD
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YYYY
Result of last A1c *
What is your goal A1c? *
How often is the applicant's blood sugar checked? *
How is the blood sugar managed (check all that apply). *
Required
At what glucose level does the applicant begin to recognize their symptoms of low blood sugar? *
How often does an out of range blood sugar reading take you by surprise? *
Are you looking for a dog to alert you to lows or highs or both? *
What range do you want to keep your blood sugar? *
What numbers would you ideally like the D.A.D. to alert to?
Do you have a yard? (this is not a requirement but helps us get to know the environment) *
Is your yard fenced?
Clear selection
Please list all members living in the home and their ages and relationship to the applicant (ie John Smith, father, 58; Jane Doe, mother, 56) *
Are there any other individuals with diabetes (or glucose related conditions) in the home? If so, please explain *
Does anyone in the household or family smoke (cigarettes or otherwise)? *
Does anyone in the home have dog allergies? *
Does anyone in the home have a fear of dogs? *
Do you have any pets currently? If so, please list species, breed (if applicable), and ages. *
Does anyone in the household have experience training dogs? If so please list who and what experience (trained a pet, attended training classes, competed in obedience or agility competitions, etc). *
What type of energy level would you like your dog to have?
Clear selection
Who will be responsible for caring for the dog? (the applicant or someone else?) *
Please describe the applicant's work/school/etc. environment during the day.
Would you expect the dog to attend work or school with the applicant? *
How many hours per day would the Diabetic Alert Dog be left at home? *
What other activities does the applicant participate in? Would you want the dog to accompany them?   *
How many hours per week are you willing to spend on continuous training of the dog? *
How do you plan on exercising your dog? (Walking, running, fetch, treadmill, biking, etc.)   *
How often would the dog accompany the applicant in public? *
Required
Are you willing and able to accept the financial obligations of a Service Dog - approximately $2,000/year? (insurance, vet bills, leashes, vests, private trainer, etc.) *
Are you aware that the fundraising fee associated with Birdi is $20,000. (MD Dogs will assist you in fundraising in any way we can if needed, such as attending fundraising events with the dog, sharing fundraising information with our community, creating a payment plan, etc. to make it feasible for someone who is the right match for Birdi.) *
Are you and all family members willing to treat the dog as a working dog rather than a pet? (e.g. follow strict rules regarding the handling of the dog - such as only the applicant feeds the dog, no excessive play by other family members, etc.) *
Have you ever had a service dog, emotional support dog, comfort dog, etc. before? If so, please explain *
We will do our best to train for night alerts, but not every dog is capable of them and it depends greatly on the dog's schedule and new environment. Do you understand that night alerts can never be guaranteed? *
If you have a Diabetic Alert Dog in public, your diabetes will never be invisible. You will receive countless comments - good and bad. Bringing a dog in public is also more like having a toddler with you, requiring more attention and supplies no matter the circumstances. If you plan to have a full public access Diabetic Alert Dog, are you comfortable with this attention? *
Have you researched Diabetic Alert Dogs and what they do? If so, how much have you researched them? *
Please explain why you would like a DAD and what goals you'd like to achieve. Feel free to add any information that would allow us to get to know you better. *
Please describe your perfect Diabetic Alert Dog's personality!  *
How did you hear about us? *
Please share a link to one of your social media accounts so we can connect! (Facebook or Instagram). (Feel free to also write "I don't have any" or "I'd prefer not to share") *
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