Clients with Service Animals

By By Lisa Bakewell

As the use of service animals increases, you will likely encounter clients who rely on them to support their health and well-being. Understanding the laws, etiquette, and considerations regarding these canine partners will prepare you for treating clients who rely on them—while also building their trust in you.

What is a Service Animal?

According to the Americans with Disabilities Act (ADA), a service animal is any dog that is individually trained to do work or perform a task (or tasks) for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability. Other species of animals, whether wild or domestic, trained or untrained, are not considered service animals.1
The ADA also defines service animals as working animals, not pets. As such, service animals are allowed in stores, restaurants, medical facilities, and many other locations that are generally off-limits to animals. This exception is not because the canine is a service dog, but because the canine is assisting a person with a disability. If the dog were alone, without its handler, it would be considered a pet and would not be allowed in unauthorized areas.

Service Animals vs. ESAs vs. Therapy Dogs

As discussed, service animals are dogs (and, in some cases, miniature horses) trained to do work or perform tasks for the benefit of a disabled individual, and are protected under the ADA. On the other hand, a dog whose sole function is to provide comfort or emotional support to its owner does not qualify as a service animal under the ADA.2 Instead, this canine would be considered an emotional support animal (ESA), because it is not trained to perform a specific job or task. One caveat: Do not confuse a service dog that is trained to sense anxiety attacks and to take a specific action to help avoid the attack or lessen its impact (such as handlers with PTSD) as an emotional support dog.
Therapy dogs are different than ESAs in the sense that they typically do have training and/or temperament requirements, although they are not necessarily expected to perform specific tasks. Therapy dogs are also excluded from ADA protection. But, while the ADA does not protect ESAs or therapy dogs, each can be found in typical “no pet” areas, including hospitals, airports, clinics, stores, restaurants, etc., doing “work” and providing comfort.

Caring for Clients with Service Dogs

Preparation is Key

Prepare for your appointment in advance, especially with a new client who has a service dog. Keep your questions simple when doing the initial client intake, but remember to ask if there is anything you need to know about interacting with them and their service dog. This way, you can work as a team. Also, consider potential barriers for your client and their canine. Will the waiting room be an issue? Will other clients be too curious or will they be uncomfortable waiting in the same lobby with an animal?

Ignore the Dog (It’s Not Rude)

When caring for a client with a service dog, remember the dog is trained to assist your client (the handler) only and should not be touched without the handler’s permission.
Do not focus too much attention on the dog or interfere with its focus by talking to it or petting it. It is best to ignore the dog completely—and it is not considered rude. A handler’s service dog is considered medical equipment and should be respected as such.
Keep in mind, too, that your client may be sensitive to questions about their disability, their service dog, or both. Just like working with any other client, don’t ask personal, unnecessary questions before client rapport is established. Many handlers are quite sensitive to others interfering with their service dog.

Know the Rules

Provide Equal Treatment

Clients with service dogs may not be isolated from others, treated less favorably than other clients, or charged additional fees because of their canine companion. Additionally, the ADA says that service dogs may not be excluded based on stereotypes or assumptions about how a particular breed might behave (according to perceived stereotypes). However, if a service animal does act in a way that poses a direct threat to the health or safety of others, has a history of such behavior, or is not under the control of the handler, that animal may be excluded. If an animal is excluded, staff must still offer services to the client in the absence of the service dog.3

Rules for MTs

According to ADA service animal laws, you may not ask about the nature or extent of a client’s disability—or require them to show proof—if a person’s need for a service dog is obvious (for example, the dog is guiding a blind individual or is pulling a wheelchair). But, if you are unsure of the nature or extent of a client’s disability, you may only ask these two questions:
• Is this animal required because of a disability? (Don’t ask: “What is your disability?”)
• What work or task has this animal been trained to perform?
While these questions are vague, they are the only questions you can legally ask. The client may respond vaguely as well (“Yes, she is a service dog and alerts to a medical condition.”), which can be frustrating, but the law prohibits asking for any further details or explanation. Also, you cannot require documentation (such as proof that the animal has been certified, trained, or licensed as a service animal) or require the animal to wear an identifying vest.4
A client handler may be asked to remove their service dog from your place of business if the dog is not housebroken or poses any threat to health and safety. Keep in mind, though, that allergies or the fear of dogs do not qualify as valid reasons to deny access to your business. If you do need to ask that a service dog be removed from your business for a legitimate reason, you must allow the client to come back without their canine companion to receive their bodywork.

Rules for Handlers

Service dogs provide a vital service for people with disabilities and are afforded several rights under the ADA. That said, handlers and their service animals do have responsibilities under the law when out in public and/or visiting business establishments.
First, service dogs must be leashed, harnessed, or tethered, according to the ADA, unless these devices interfere with the dog’s work—or the handler’s disability makes it impossible to use these restraints. In that case, the service dog must be kept under control through its handler’s voice or other signals.
Second, it is the handler’s responsibility to ensure that their service dog is properly trained and behaves appropriately in public. If a service dog is aggressive and the handler cannot control it, you are permitted to ask that the animal be removed from your business.

One MT’s Experience

At The Mommy Spa in Los Gatos, California, owner and operator Lindsay MacInnis recalls working with three client/service dog teams. “Two were fine,” MacInnis says, “but one client’s ‘service dog’ was not really a trained service dog. The dog no doubt helped the client with her anxiety, but [it] was aggressive toward other people.” Because of this aggression, MacInnis made arrangements to visit her client in the client’s home.
When working with client/service dog teams, MacInnis says she puts a blanket on the floor of her treatment room for the dog to lie down on and relax. “Our office is dog friendly,” she says, “so it’s not a problem.” Her office is also large enough and provides plenty of space, so the service dog is not underfoot.
One consideration, MacInnis says, is the possibility that clients may be allergic to animals. “Since it is mostly saliva and urine that people have allergic reactions to,” she says, “I make time to quickly mop the floor, and I have an air cleaner I can run.” One client claimed to be allergic to dogs, but “in truth, turned out to be [afraid] of dogs,” according to MacInnis. To remedy the situation, she scheduled more time between clients to “quickly mop the floor and avoid contact.”
Regarding ESAs, MacInnis says she welcomes emotional support animals if they are nonaggressive and well socialized. “It’s a bit tricky,” she says, “as it’s pretty easy to establish an animal as an ESA these days. But, as an animal lover, I really have no problem with this.”

Federal Americans with Disabilities Act service animal laws are very clear—and these laws apply throughout the US—but there are also service animal laws in each state, county, city, and authority. For further clarification and additional requirements, check your local laws. For additional information about your state, visit the “Table of State Service Animal Laws” at

If a service dog tries to get your attention, respond. Many service dogs are trained to alert others in an emergency. You may be called upon by the canine to alert a family member, activate an alarm, or dial 911. If the service dog approaches you and is barking, attempting to get you to follow, etc., please pay attention. You may just save a life.

What About Insurance?

Debbie Higdon, in ABMP’s Risk Management department, says that the liability insurance that is a benefit of ABMP membership is designed to cover your negligence, not the negligence of others. “If a client’s animal/service animal gets aggressive and bites, it is the dog’s owner who is liable and should take responsibility,” Higdon says. According to ADA requirements, it is the handler’s responsibility to keep their service dog under control. Hopefully, the handler’s policy covers this liability, but you cannot ask the dog owner if they have liability coverage!

Even if you are allergic to pet dander or have a fear of dogs, by law you are not allowed to deny access or refuse service to a client with a service animal. If a client is allergic to pet dander and they must be present in the same room or facility as a person with a service animal, both the client and the person with the service animal should be accommodated by assigning them to different locations within the facility if possible.

Miniature Horses as Service Animals

Miniature horses are not included in the service animal definition, which is limited to dogs; however, the 2010 ADA regulations contain a specific provision covering their use as service animals. The provision states that businesses must make reasonable modifications in policies, practices, or procedures to permit the use of a miniature horse by an individual with a disability if the miniature horse has been individually trained to do work or perform tasks for the benefit of the individual with a disability, and:
• The horse is housebroken
• The horse is under the owner’s control
• The facility can accommodate the horse’s type, size, and weight
• The horse’s presence does not compromise safety requirements
For more information, visit


1. ADA National Network, “Service Animals,” 2017, accessed February 2020,
2. US Department of Justice, “Frequently Asked Questions about Service Animals and the ADA,” 2015, accessed February 2020,
3. US Department of Justice, “Frequently Asked Questions about Service Animals and the ADA.”
4. US Department of Justice, “Frequently Asked Questions about Service Animals and the ADA.”

Lisa Bakewell is a full-time freelance writer, editor, perpetual learner, and lover of life in Chicagoland. Her areas of writing expertise include health and wellness, travel, parenting, personal/company profiles, technology, and a plethora of “how-to” articles (her favorite!). She can be reached at