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Service Dog Intake, Evaluation, and Private Registry Application

Birthday
Month
Day
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1. Is the dog required because of a disability?
Yes
No
2. Areas of Assistance (Select all that apply.)
Mobility/Walking
Balance/stability
Retrieving objects
Hearing/sound awareness
Vision/navigation
Medical alert/response
Seizure-related assistance
Psychiatric episode assistance
Autism-related assistance
Other
3. What tasks does your service dog perform for you? (Select all that apply.)
Retrieving objects
Open/close doors
Balance assistance
Interrupt panic attacks
Guidance/navigation assistance
Alert to medical conditions
Hearing alerts
Medication reminders
Other

Current Dog Information

Consent

Important Notice


Please read this notice carefully before submitting your application.


Our organization offers a private Service Dog Registry and may issue an organizational certificate. Registration confirms that the information you submitted has been reviewed and recorded in our organization’s database.

Our certificate and registration are issued by our organization only. They are not government-issued or government-recognized and do not, by themselves, establish legal service dog status or guarantee public access rights. Service dog rights and protections are determined by applicable laws and may depend on whether the dog meets the applicable legal definition of a service animal.


By submitting this application and questionnaire, you acknowledge and agree that:


  • The information you provide is true and complete to the best of your knowledge.

  • You are requesting registration in our organization's private Service Dog Registry.

  • Any certificate and registration issued are provided by our organization and are not issued by any government agency.

  • You understand that registration alone does not determine a dog's legal status under applicable laws.

  • You consent to our collecting and securely storing and maintaining the information you provide as part of our registration records.

  • You have read, agree and understand this notice.

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National Service Dog Association

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The Americans with Disabilities Act (ADA) and the Fair Housing Act (FHA) do not require service dogs to be registered or certified. There is also no official federal registration database for service dogs.

NSDA offers voluntary registration and identification services for service-dog handlers who choose to use them.

NSDA registration is intended to provide voluntary identification and documentation and to support responsible service-dog handling. Registration is not required by federal law and does not guarantee access to public places, housing, transportation, or other locations.

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© 2026 by National Service Dog Association LLC. All rights reserved. 

 

National Service Dog Association
North Bellmore, NY 11710
Phone: 516-761-3243
Email: Nationalsvcdogassoc@gmail.com

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​​​Important Legal Notice

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National Service Dog Association is an independent, private organization. We are not a government agency and are not affiliated with the U.S. Department of Justice, the U.S. Department of Housing and Urban Development, or any other federal agency.

Any registration, identification card, certificate, or documentation provided by NSDA is voluntary and privately issued. It does not create legal rights under the ADA or FHA and does not guarantee public access.

Federal, state, and local laws may have different requirements. Customers and handlers are responsible for understanding the laws that apply to their individual circumstances.

For official information about service animals and the ADA, visit ADA.gov.

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