Client Payment Submission Form

Please complete this form for each payment submitted for your service dog.  This is only required for payments not submitted via fundraising campaigns on our website. 

A receipt will be sent to you upon submission so that you may track all of your payments.

Clients that fail to submit this form with each payment that then require an accounting history request in order to track payments made will be charged a $50 accounting service fee .

Thank you!

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