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Department of Transportation Service Animal Travel Form
DOT Service Animal Form
Please complete all fields below. Upon submission, you will receive an email with the completed PDF copy of the required DOT Travel Form.
Warning: It is a Federal crime to make materially false, fictitious, or fraudulent statements, entries, or representations knowingly and willfully on this form to secure disability accommodations provided under regulations of the United States Department of Transportation (18 U.S.C. ยง 1001).
Service Animal Handler's Name
*
Phone
*
Service Animal Handler's Email
*
Animal's Name
*
Animal Color / Markings
*
Animal Breed
*
Animal Weight (lbs)
*
Date Rabies Vaccine Administered
*
MM slash DD slash YYYY
Date Rabies Vaccine Expires
*
MM slash DD slash YYYY
Veterinarian's Name
*
Veterinarian Phone Number
*
Name of Service Animal Trainer
*
Insert name or organization that trained your service animal. NOTE: If you trained your service animal yourself, insert your name
Trainer's Phone Number
*
If you trained your service animal yourself, enter your own phone number
Check 1 or Both Boxes:
*
My Service Animal will not need to relieve itself while on the aircraft
My Service Animal can relieve itself without posing a health/sanitation issue
Describe how your Service Animal will refrain from relieving itself, or relieve itself without posing a health/sanitation issue (e.g., the use of a dog diaper, animal will be taken to bathroom prior to arrival at airport, animal can hold it in for duration of flight, etc)
*
Consent
*
I am signing an official document of the U.S. Department of Transportation. My answers are true to the best of my knowledge I understand that if I knowingly make false statements on this document, I can be subject to fines and other penalties.
My Service Animal has been trained to do work or perform tasks to assist me with my disability. My Service Animal has been trained to behave in a public setting. I understand that a properly trained dog remains under the control of its handler. I understand that a properly trained dog does not act aggressively by biting, jumping, lunging, or injuring other animals. It also does not urinate or defecate on the aircraft or in the gate area. I understand that if my service animal shows that it has not been properly trained to behave in public, then the airline may treat my service animal as a pet by charging a pet fee and requiring my service animal to be transported in a pet carrier. To the best of my knowledge, my service animal has not behaved aggressively or caused serious injury to another person/dog. I understand that my service animal must be harnessed, leashed, or tethered at all times in the airport and on the aircraft. I understand that if my service animal causes damage, then the airline may charge me for the cost to repair it, as long as the airline would also charge passengers without disabilities to prepare the similar kinds of damage.
How would you like to sign this document?
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Electronically
Manually
Signature
*
