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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
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Hearing Dog Application: To
apply for a Hearing Dog, you will need to fill out the
application and send it back to us along with an audiogram
from an audiologist. After your application has been
reviewed, you will be notified as to whether or not you
qualify for the next step. That next step will be an
in-home interview by one of our Instructors.
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We are a 501 C3 non-profit organization privately funded
through the generosity of Mr. Sam Simon so we do not accept
any public donations.
WE OFFER THESE SERVICES FREE OF COST TO ALL RECIPIENTS OF OUR
PROGRAMS. |
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Mail inquiries: The Sam Simon Charitable Foundation |
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30765 Pacific Coast Hwy #113
Malibu, CA 90265 |
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