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PSD
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PSD Questionnaire
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PART A: PERSONAL DETAILS
-
Step
1
of 6
If you want to qualify for a psychiatric service dog letter, we will connect you to licensed mental health practitioners who will review your condition. But the first step is filling out our questionnaire. We will ensure the information you provide is kept confidential.
Your Official Legal Name
*
First
Last
Gender
*
Male
Female
Other
Confirmation 18 years old
*
I confirm I am at least 18 years old and not acting on behalf of anyone else. *
Date of Birth
*
Must be an adult 18+
Email Address
*
Email
Confirm Email
Phone Number
*
Do you want to own a psychiatric service dog?
*
Yes
No
NOTE: A PSD can only be a dog and no other type of animal. Also, the PSD should be well trained to help you perform specific tasks limited by your disability.
Next
Have you experienced any mood swings or changes in the last 6 months?
*
Yes
No
Have experienced any of the following symptoms in the last 6 months
Fatigue
Extreme anger or irritability
Depressed or elated mood
Restlessness
Changes in sleep patterns
Muscle tension
Suicidal thoughts
Wanting to hurt others
Not interested in performing activities you once enjoyed
Sudden weight gain or loss
Sudden increase or loss of appetite
Unable to make a clear decision
Isolation and feeling lonely
Performing poor at school or work
Feeling sad
Other
None
Have of you been feeling sad or depressed
*
Yes
No
If yes, how long for the symptoms persist?
*
Less than 1 hour
1-3 hours
3-5 hours
Greater than 5 hours
Do you often feel anxious?
Yes
No
If yes, for how long do you feel anxious?
*
Less than 1 hour
1-3 hours
3-5 hours
Greater than 5 hours
Does feeling anxious and depressed interfere with everyday life activities such as sleeping, eating, working, and speaking?
Yes
No
Major Life Activities include, but are not limited to, caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working.
If yes, how do the symptom affect normal life activities?
Previous
Next
Have you in experience any traumatic life events?
*
Yes
No
If yes, have you experienced any of the following symptoms due to a past traumatic event?
Other
Dreams about the traumatic events
Flashbacks
Avoiding remembering the negative aspects of the event
Difficulty in recalling essential aspects of the vent
Negative feelings about yourself
Not feeling to associate with others
Difficulty in feeling happy
Self-destructive behavior
Easily angered
Others specify
In the last three months, how have the traumatic events bothered you?
Rarely
Moderately
Very Often
Other
Do the symptoms of traumatic events affect your everyday activities, such as eating, sleeping, working, and walking, among others?
Yes
No
Major Life Activities include, but are not limited to, caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working.
If yes, how have the symptoms affected your everyday life activities?
Previous
Next
Have you experienced any intense fear or anxiety for no apparent reason?
*
Yes
No
If yes, how often do you experience intense fear or anxiety?
Daily
Several times a week
A few times per month
Never
Other
Are you afraid of having anxiety and panic attacks in the future?
Yes
No
During the last anxiety and panic attack, did you experience any of the following?
Increased heart rate
Uncontrollable shaking
Dizziness or nausea
Difficulty breathing
Hot flashes or profuse sweating
Numbness of extremities (legs, fingers, toes, etc.)
None of the above
Do the anxiety or panic attacks interfere with everyday life activities such as sleeping, walking, and eating?
Yes
No
Major Life Activities include, but are not limited to, caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working.
If yes, how does it affect your everyday life activities?
Previous
Next
Have you been diagnosed with any psychological or physical disorder in the past?
*
Yes
No
If yes, were you given any medicine, and how long have you used them?
Kindly share anything else you wish with the licensed mental health practitioner.
Previous
Next
Discount Code
Please enter your redemption code
OUR PSD LETTER
*
Price - $ 159.00
OUR PSD LETTER (10% OFF)
*
Price - $ 143.10
OUR PSD LETTER (100% OFF)
*
Price - $ 0.00
OUR PSD LETTER (99% OFF)
*
Price - $ 0.05
OUR PSD LETTER (85% OFF)
*
Price - $ 23.85
OUR PSD LETTER (15% OFF)
*
Price - $ 135.15
OUR PSD LETTER (20% OFF)
*
Price - $ 127.20
OUR PSD LETTER (25% OFF)
*
Price - $ 119.25
Automatic Annual Renewal
You should opt for the Automatic PSD Letter Renewal at a discounted rate of 125.00$
By opting for the automatic annual renewal service, we will automatically renew your letter at a discounted rate of $ 125 rather than a standard fee of $ 199. The service is optional, and we will inform you when it is time to update your information.
Automatic Annual Renewal (10% OFF)
You should opt for the Automatic PSD Letter Renewal at a discounted rate of 112.50$
By opting for the automatic annual renewal service, we will automatically renew your letter at a discounted rate of $112.50 rather than a standard fee of $ 199. The service is optional, and we will inform you when it is time to update your information.
Automatic Annual Renewal (15% OFF)
You should opt for the Automatic PSD Letter Renewal at a discounted rate of 106.25$
By opting for the automatic annual renewal service, we will automatically renew your letter at a discounted rate of $106.25 rather than a standard fee of $ 199. The service is optional, and we will inform you when it is time to update your information.
Automatic Annual Renewal (20% OFF)
You should opt for the Automatic PSD Letter Renewal at a discounted rate of 100$
By opting for the automatic annual renewal service, we will automatically renew your letter at a discounted rate of $100 rather than a standard fee of $ 199. The service is optional, and we will inform you when it is time to update your information.
Automatic Annual Renewal (25% OFF)
You should opt for the Automatic PSD Letter Renewal at a discounted rate of 93.75$
By opting for the automatic annual renewal service, we will automatically renew your letter at a discounted rate of $93.75 rather than a standard fee of $ 199. The service is optional, and we will inform you when it is time to update your information.
Expedited Service - Rush Digital Delivery
Rush Digital Delivery service at - $ 49.50
If you need your PSD letter as soon as possible, we are proactive to hasten the process and provide it ASAP. However, you will not be eligible for a refund if you decide to cancel your order.
Expedited Service - Rush Digital Delivery (10% OFF)
Rush Digital Delivery service at - $ 44.55
If you need your PSD letter as soon as possible, we are proactive to hasten the process and provide it ASAP. However, you will not be eligible for a refund if you decide to cancel your order.
Expedited Service - Rush Digital Delivery (15% OFF)
Rush Digital Delivery service at - $ 42.08
If you need your PSD letter as soon as possible, we are proactive to hasten the process and provide it ASAP. However, you will not be eligible for a refund if you decide to cancel your order.
Expedited Service - Rush Digital Delivery (20% OFF)
Rush Digital Delivery service at - $ 39.60
If you need your PSD letter as soon as possible, we are proactive to hasten the process and provide it ASAP. However, you will not be eligible for a refund if you decide to cancel your order.
Expedited Service - Rush Digital Delivery (25% OFF)
Rush Digital Delivery service at - $ 37.13
If you need your PSD letter as soon as possible, we are proactive to hasten the process and provide it ASAP. However, you will not be eligible for a refund if you decide to cancel your order.
Place of Residence
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
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Total
$ 0.00
How would you like to pay?
*
Credit card
Credit Card *
Stripe Credit Card
*
Card
Name on Card
Terms and Conditions
*
I have read understood, and agreed to the Terms and Conditions and the following additional things: *
A psychiatric service dog should undergo comprehensive training to perform various tasks; The PSD should help perform activities limited by your mental disability. The PSD letter issued help to ascertain whether you qualify for the PSD. You can submit the letter to your housing providers or airlines so that they can accommodate your service dog. It is imperative to note the PSD letter does not confirm that you own a service dog. Service Paws USA and healthcare professionals can not select for you a service dog. You are responsible for selecting a service dog that caters to your needs. Using false information to certify a pet as a service animal is also illegal. The refund policy will be considered if you decide to cancel your request.
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