Dog Guide Handlers Australia
Dog Guide Refusal Incident Report

Please return this completed form to dgha@dgha.org.au 

Dog Guide Handlers Australia (DGHA) is an independent non profit association of Dog Guide Handlers and is not affiliated with any Dog Guide organisation. We provide an independent voice for Australians who use Dog Guides as mobility aids.

Our board is becoming acutely aware of the need for advocacy around Dog Guide refusals in Australia with continuing reports on our social media channels and from our members facing refusals to taxi and rideshare services, hospitality venues, accommodation providers and various other businesses and services.

As part of our mission to foster, represent, promote, enhance and protect the interests of Australians who are Dog Guide handlers, we are asking people who use Dog Guides as mobility aids across Australia to share the details of any refusal incidents to support our advocacy work. We aim to capture a detailed picture of the scope of this discrimination problem so that we can address the legislation at Government level.

We are not using this information to advocate individually for those who report incidents using this form, this data will be used only for systemic advocacy.

This form will remain available indefinitely so that we capture a long term picture of the situation around Dog Guide refusals in Australia.

The information we collect in this form will only be shared in an unidentifiable format. All of the questions in this form require an answer.
Please only report one incident per form and incidents that have occurred from 2022 onwards. If you need to report more than one incident, please start again with a fresh form for each incident.

If your form opens in protected mode, use function key 6 then tab to enable editing and enter.

If for some reason you are unable to access this form, or the online form, please contact DGHA by emailing dgha@dgha.org.au.

Visit our website www.dgha.org.au

1.	Your Email Address:

2.	What was the day, month and year the incident occurred? 

3.	In what state or territory did the incident take place? 

4.	Which town, city or suburb did the incident take place? 

5.	What time of day did the incident occur? 

6.	Which of the following did the incident take place at? 

Eatery, Retail or business, Rideshare/taxi, Public transport Accommodation, Other

7.	What was the name of the business? (we will not share this information with anyone or contact the business) 

8.	Please describe the incident in your own words in as much detail as possible. 

9.	What was the outcome? 

10.	Have you taken legal action or reported to an authority?

11.	How has this refusal experience affected you?

12.	Would you please provide a contact number for us to clarify any details in your submission?

13.	Do you give consent for Dog Guide Handlers Australia to share the details of this incident without sharing your identity? Yes or No

14.	Where did you hear about this form?