When a patient comes into your office with a dog what do you do? Can you turn them away? Are there specific restrictions?
Service dogs are regulated under the Americans with Disabilities Act (ADA), the Department of Justice (DOJ), Civil Rights Division, the California Disabled Persons Act (CDPA), the Unruh Civil Rights Act, and the Fair Employment and Housing Act (FEHA).
In the 2019 case of C.L. v. Del Amo Hospital, Inc., the court addressed whether a hospital’s refusal to accommodate a patient’s self-described service animal violated ADA. The patient, C.L., who suffered from severe childhood trauma, major depression, and anxiety, relied on her service dog to wake her from nightmares, alert her to people approaching, and “ground” her. Despite being unable to afford a professionally trained service dog, she purchased a dog and trained it to assist with her specific needs. The district court ruled in favor of Del Amo Hospital because C.L. failed to prove that her dog was a “service dog.” After a bench trial, the judge found it decisive that she “did not receive a certification of the dog as a service animal.”¹ The plaintiff (patient) appealed this decision.
In 2021, the U.S. Court of Appeals for the Ninth Circuit vacated the district court’s judgment in favor of the defendant in her action seeking injunction relief under Title III of the ADA, which prohibits discrimination in “places of public accommodations,” including hospitals.² The court also determined that the ADA prohibits certification requirements for qualifying service dogs for several reasons:
1) the ADA defines a service dog based on its function rather than specific training requirements, 2) the DOJ regulations and guidance have opposed a formal certification mandate, and 3) permitting individuals with disabilities to self-train a service animal aligns with the ADA, as other forms of training may be excessively costly. Therefore, the district court’s imposition of a heightened requirement on C.L.’s dog was deemed inconsistent with the ADA.
Service Animal Defined
Under the ADA, a service animal is defined as a dog that has been individually trained to do work or perform tasks for an individual with a disability. The task(s) performed by the dog must be directly related to the person’s disability.³ Tasks can be related to either physical or psychiatric issues. The provision of emotional support, well-being, comfort, or companionship does not constitute work or tasks for the purposes of this definition. Therefore, those individuals claiming to have a “companion animal” or “comfort animal” does not meet the definition of a “service animal” under the ADA, and do not need to be accommodated under the ADA.4
Where are service dogs allowed?
Under the ADA, state and local governments, businesses, and nonprofit organizations that serve the public generally must allow service animals to accompany people with disabilities in all areas of the facility where the public is allowed.5 Under California law, the disabled individual also has the right to take a service dog into a physician’s office or other place of public accommodation.6
Upon a patient’s arrival at the office with their dog, the initial step is to ascertain if the dog is a service animal. You are limited to asking only two questions to determine if the dog meets the legal criteria of a service animal: “Is your dog a service animal?” and “What work, or task has the dog been trained to perform?” These tasks can be picking up a dropped item, alerting individuals to the presence of allergens, providing physical support and assistance with balance, or helping a person with psychiatric disabilities by interrupting impulsive behaviors. You cannot require the individual to demonstrate the task or request any documentation that the animal has been certified, trained, or licensed as a service animal. There are no registration, certification, or identification requirements needed to demonstrate the animal is a service dog. The determination of whether the dog is a service animal should be objectively documented by including the patient’s answers to the two questions in the patient’s record (“patient presented with service dog, stated it is trained to pick up dropped items”).
When Service Animals Are in the Office
Under the laws, service animals must be under the individual’s control and are required to have a harness or leash and be housebroken. The service animal can be removed if it poses a direct threat to the health or safety of others. Be sure to objectively document the behavior and the discussion. Understand that the service animal is working, so staff and other patients should not interact with it.
While you must provide reasonable accommodation for the service dog, you are not obligated to walk, entertain, or clean up after the dog. The animal is entirely the owner’s responsibility. If other patients are allergic to dogs, then reasonable isolation precautions must be taken to accommodate everyone. You cannot exclude a service dog because another patient has a dog allergy. In no event should dogs be allowed in sterile settings such as operating rooms because of the risk of infection.
It is recommended that you establish or review your office policy and ensure that it includes (1) the definition of a service animal, (2) the duties of both staff and patients related to service animals, (3) criteria for excluding or removing animals, and (4) information about the required documentation. The information should be communicated to both staff and patients, with information available in patient intake materials and office signage. 
Deborah Kichler, RN, MSHCA, is a Senior Risk Management and Patient Safety Specialist. Questions or comments related to this article should be directed to DKichler@CAPphysicians.com.
Resources
¹Del Amo Hospital, 2019 WL 4187848, at #6.
²C.L. v. Del Amo Hosp., 2019 WL 4187848, at *6 (C.D. Cal. Sept. 3, 2019).
³U.S. Department of Justice. “Frequently Asked Questions About Service Animals and the ADA.” ADA.gov. Accessed November 10, 2025. https://www.ada.gov/topics/service-animals/.
4California Medical Association. California Physician’s Legal Handbook: Disabled Patients—Health Care Service. July 2023, 5.
5U.S. Department of Justice. “ADA Requirements: Service Animals.” ADA.gov. Accessed November 10, 2025. https://www.ada.gov/topics/service-animals/.
6California Medical Association. California Physician’s Legal Handbook: Disabled Patients—Health Care Service. July 2023, 4.
Other resources
Introduction to State and Federal Disability Rights Laws - Legal Rights of Persons with Disabilities https://oag.ca.gov/system/files/media/drb-intro-state-fed-laws.pdf