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Dear Applicant; Thank you for your interest in a Hearing Dog from The Sam Simon Foundation. Please download and fill out the Hearing Dog Application and mail it along with a current audiogram. If you have a total hearing loss, and do not have the assistance of Hearing Aids or a Cochlear Implant, please just include the date you were last tested. Your audiogram must include testing with and without aids on. Once we have had an opportunity to evaluate your application, we will notify you by mail if you qualify to go on to an in-home interview. If you have any questions about your application or the audiogram, please notify us by email or phone. Please send your completed application and audiogram to The Sam Simon Foundation, 6070 Ramirez Canyon Road, Malibu, CA, 90265. We look forward to receiving your application and thank you for your request. Sincerely, The Sam Simon Foundation Assistance Dogs Program Hearing Dog Program
Download Hearing Dog Application (pdf)
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