When it comes to hospital access rights for Service Dogs, United States federal law permits Service Dogs to accompany their disabled handler into in non-sterile, public areas. Cut through the chaos with this plain English explanation of the rules, exceptions, laws, requirements and expectations for Service Dog hospital access.
Service Dog Hospital Access Rights: The Basics
To make a long story really short, Service Dogs are allowed in hospitals, doctor’s offices, patient rooms, and other health care facilities as long as their presence doesn’t pose a threat or danger to standard medical practices and doesn’t impede operations of fundamental services and functions.
Professional offices of health care providers and hospitals are specifically mentioned in subchapter III, Section 12181 (definitions), point 7 (Public Accommodations), part F, as being a “public accommodation,” and federal law goes on to state,
“Individuals with disabilities shall be permitted to be accompanied by their service animals in all areas of a place of public accommodation where members of the public, program participants, clients, customers, patrons, or invitees, as relevant, are allowed to go.”
As quoted directly from the ADA and the U.S. Code of Federal Regulations, here are other pertinent parts of federal Service Dog law that grants hospital access to Service Dog teams:
(a) General. A public accommodation shall make reasonable modifications in policies, practices, or procedures, when the modifications are necessary to afford goods, services, facilities, privileges, advantages, or accommodations to individuals with disabilities, unless the public accommodation can demonstrate that making the modifications would fundamentally alter the nature of the goods, services, facilities, privileges, advantages, or accommodations.
(4) Animal under handler’s control. A service animal shall be under the control of its handler. A service animal shall have a harness, leash, or other tether, unless either the handler is unable because of a disability to use a harness, leash, or other tether, or the use of a harness, leash, or other tether would interfere with the service animal’s safe, effective performance of work or tasks, in which case the service animal must be otherwise under the handler’s control (e.g., voice control, signals, or other effective means).
(5) Care or supervision. A public accommodation is not responsible for the care or supervision of a service animal.
If you’re interested in learning more about U.S. federal Service Dog, check out this point-by-point breakdown in plain English. Consider carrying this official ADA brief on Service Dog law or our one-page Service Dog law handout just in case you encounter issues.
Service Dog Hospital Access Rights: The Problems
If a Service Dog handler requires admission to the hospital, there’s likely something wrong, either medically or psychiatrically, that requires medical attention, intervention or assistance. In other words, the handler is sick. When someone is sick, they’re often not able to function normally, especially within the context of “hospital admission.” Many hospital admissions require the use of medical equipment (like heart monitors or an IV) that may limit the ability of the handler to move around. Federal law requires the handler to be in direct control of their Service Dog and further stipulates that staff, employees, or other individuals cannot be expected to care for the dog in any way. If a handler can’t move around effectively or is too sick or too unaware or otherwise unable to care for their Service Dog (feeding, exercising, taking out, cleaning up after), then, under federal law, there’s an issue.
Hospitals are highly regulated, oftentimes sterile, environments, and disease control is incredibly high on the priority list. It’s a well-documented fact that therapy dogs have been at the root of several cases of MRSA outbreak and spread within hospitals and there have been isolated cases of other infectious disease outbreaks that have traced back to dogs on the premises. Federal law is quite clear, though: even when the health codes prevent access by pets or animals, Service Dog teams are allowed.
However, that’s not a free-for-all. The access of a Service Dog team can’t fundamentally alter the way a “public accommodation” does business or provides their service. In a hospital, that means the presence of the Service Dog can’t violate standards that are in place for patient or staff safety and are medically necessary.
Service Dog Hospital Access Rights: The Real Facts
Here’s what hospital access rights for Service Dog teams actually look like: the Service Dog and handler are allowed anywhere visitors are allowed without special precautions. For example, visitors are allowed in patient rooms, the gift shop, cafeterias, some labs, and other “public” areas of the hospital. However, visitors AREN’T allowed in the maternity ward, ICU, burn units or other areas where special footwear, masks, or specific and medically necessary precautions are taken for the
safety of the individuals on that unit or in that area. Visitors AREN’T allowed in operating suites or rooms or in other biologically sterile areas, and visitors aren’t allowed in trauma areas or specific triage units specializing in disease control, burns or potentially infectious open wounds. Depending on the attending physician and the specific emergency, visitors may or may not be allowed in certain emergency rooms or situations.
Service Dog Hospital Access Rights: An Awesome Example
Johns Hopkins Hospital, associated healthcare units and affiliated university medical study facilities offer an excellent example of Service Dog hospital access rights in their “Service Animal for Patient/Visitor Policy.”
Their policy is ADA compliant, accurate, detailed and offers specific information for the restrictions, use and requirements of a Service Dog in the hospital.
Great Lakes ADA Center offers a Model Service Animal Policy for Hospitals handout that may come in handy if your local hospital or hospitals you visit or utilize the services of regularly don’t have a written policy.
Service Dog Hospital Access Rights: Things to Consider
There’s an old saying that goes something like this: “Just because you can do something doesn’t mean you should.”
Before bringing your partner with you to the hospital, especially for a lengthy stay or during an emergency, ask yourself the following questions:
1.) Are you well enough or stable enough to take care of your partner?
2.) If you’re not, can you make arrangements for someone else (a family member or friend, NEVER staff) to care for your partner?
3.) Will your partner be safe? Consider whether you’ll be aware enough to properly look out for your partner’s best interests, whether or not she will be exposed to pathogens, dangerous substances or highly charged situations over which you can’t help her cope, and whether or not she has the skills and training necessary to keep herself calm, quiet, settled and out of the way at all times.
4.) Will you be safe? Consider whether your partner is familiar enough with medical procedures and equipment to not be in the way, not prevent doctors and nurses from doing their job, and not create problems that otherwise wouldn’t be there, like knocking over IV poles, tearing out lines or leads and unplugging machines.
5.) Will those around you, including nurses, other patients, doctors and visitors who don’t know you, be safe? Is there a possibility your Service Dog’s presence might be dangerous to anyone for any reason?
6.) How does your partner respond to high levels of stress and uncertainty? Even the most well-trained Service Dog can react poorly during highly charged events, especially if they’re not familiar with the circumstances. Keep in mind yourself, your partner AND those who must provide care to you. If you’re unconscious, non-responsive or coding and your partner displays any protective behavior (which is, by the way, unsuitable for Service Dogs, but isn’t unheard of in high-stress environments), typically, your partner will be removed from the situation and collected by Animal Control as quickly as possible so medical staff can tend to you.
7.) How is your partner’s training? Be brutally honest with yourself. If your Service Dog isn’t capable of laying quietly on a blanket, mat, or bed for hours on end with little interaction, stimulation and under exceedingly high levels of distraction, whether you’re present or not (consider that you may be taken out of your room to radiology, the lab or for other testing and your partner must remain behind for her safety), and without interfering with doctors, nurses and visitors in any way, she may not be ready for a hospital trip.
8.) If your partner isn’t settling in as well as you would have hoped, can you make alternate arrangements for her? Would a friend or family member be able to come pick her up and care for her until you were able to do so?
9.) Do you have a plan in place in case you’re transferred to a unit where your Service Dog wouldn’t be able to accompany you?
10.) Does your partner possess the training and skills required to navigate the unique environment the hospital presents? For example, if you’re on a locked unit, is your partner capable of using large potty pads on command, as you won’t be able to leave the unit? Is your partner able to successfully move with you and work with you while you’re hooked up or surrounded by unfamiliar equipment, smells and sights? Is your partner able to be a calming, healthy presence during your stay?
Service Dog Hospital Access Rights: The Hospital’s Rights
- To be able to operate normally with regards to the movement, care, safety, treatment and recovery of patients and staff.
- To remain as disruption free after your partner is on-site as they were before your partner arrived. This means they have the right to ZERO interruption, disruption or harassment from your partner in any way, shape, form or fashion, unless your partner is performing necessary task work that does not impede your treatment or infringe on the rights of others in any way.
- To not have to take care of or otherwise interact with your partner. Staff members have the right to not be expected to “take your partner out,” feed, water or otherwise care for your Service Dog in any way. If you’re too sick or too unstable to care for your partner or to make arrangements for someone else (a friend or family member) to care for your dog, you’re probably too sick to have your partner on-site during a hospital stay.
- To be able to abide by the same safety, sanitary, and medical expectations they always operate under. Hospitals have strict protocols regarding visitor and staff expectations, dress and access to certain areas of the building, especially in environments where highly unstable, very young or very old, immunocompromised or severely injured patients are recovering and being treated.
- To be able to ensure the hospital environment remains, first and foremost, an environment of healing and recovery.
Service Dog Hospital Access Rights: The Service Dog Team’s Rights
- To be able to access non-sterile and non-medically regulated patient and visitor areas.
- To be able to request “reasonable accommodation” for the canine partner.
- To have the treatment team focus on the patient, not the Service Dog.
- To receive the exact same treatment, care, respect and communications someone without a Service Dog would receive.
- To not have their Service Dog distracted, interacted with, moved or otherwise molested without permission, except in the event of an emergency.
We’ve heard hundreds of stories of highly successful hospital stays with a Service Dog. However, before arranging for your Service Dog to stay with you at the hospital, ensure your partner is going to be a HELP, not a hinderance. Your first focus while you’re at the hospital needs to be getting better and recovering, not on stressing over or trying to manage your partner’s behavior, training or responses.
What about you and your partner? Have you guys been hospitalized as a team? How did it go?
Robin J. October 3, 2013
Nice article, and very clear!
I did want to mention that the blog article does not apply to VA hospitals or other VA facilities, whether you’re a visitor or a patient, as the VA is exempt from the ADA. Since VA facilities handle about 6 million patient visits per year, this does affect quite a few in the service team community.
A federal law did pass in 2012 requiring VA facilities to grant access to teams from ADI or IGDF accredited programs, but it’s up to each facility manager to decide how to handle dogs from other programs or owner trained dogs. And even teams from ADI/IGDF programs may have to show ID.
The law was titled `Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012′. The relevant passage is in section 109.
So if it happens that the hospital you’re considering is a VA facility, it’s best to check with them in advance to see which policies will apply. Don’t just rely on a VA facility website that says “service dogs are allowed” as a VA facility may limit the definition of “service dog” to dogs from specific programs, they’re not required to use the ADA definition.
Kea Grace October 6, 2013
Thank you for the clarification, Robin!
Did you receive the email inviting you to guest write a post for us?
Robin J. October 6, 2013
Thank you, I’m going to have to pass. It would be best if you can get
an attorney or disability rights specialist for something like that, I
Monica October 12, 2013
A friend of mine unfortunately found that out when she went to and army base hospital to visit a family member and was told her SD would not be allowed to accompany her on the visit. She was upset and called me. I had to explain to her that this was a fact. It pays to make yourself familiar with laws and protocol of various facilities especially military facilities.
Jean McLean August 12, 2014
Thank you Robin. I must say that with all the recent negative press about the VA, they have been more than accommodating of my husband’s SD. He had open heart surgery at the Boston VA hospital and the staff arranged for a private room in the recovery area within hours of the completion of the surgery. For the first 4 hours post op, they asked me if we would stay in the waiting room as there was one nurse for every two patients and my husband needed to be in her sight line. I agreed and once the four hours elapsed, he was moved to a private room, still within the Recovery area. After that,his SD was with him in his room and throughout his three week rehab (also at the VA.) I stayed on the hospital grounds in their Fisher House, and again had no difficulties about the dog staying with me at night.
Monica October 12, 2013
I had a total knee replacement in 2008. I did not take my SD to the hospital with me. I knew I would not be able to care for her. It was a good choice because I ended up being very ill. I was in a rehab facility for nearly three weeks. However my SD was able to participate in my therapy after I came home. My therapist was most impressed with how my SD adjusted to having to do things differently in her mobility assist job.
Littlewolf December 11, 2013
Can you provide links to info about therapy dogs contributing to MRSA problems? I’d like to see the data for myself. Thanks!
Katie April 8, 2014
I had to have reconstructive surgery on my back and the hospital manager was rude and told me that they could turn down SD unless the SD had a certification. I had contacted an ADA rep to speak with the person because my SD is owner trained. I had to fight for them to allow her in to help me but once we got past that I had family members take care of her and bring her in when I had PT during my stay. They were impressed with how well she adapted to help with my mobility. If it weren’t for the ADA rep calling multiple times and talking to the manager I would have had a difficult time getting my SD in.
Mary Anne Doyle January 7, 2015
I was denied access to my local ER back in September because of my service dog. This hospital has a therapy dog program and the guard, not knowing the difference between service and therapy dogs, refused to allow me access because my dog “was not registered with the hospital”. He even checked with his supervisor. It was like talking to a brick wall when I tried to explain. I did send an email and received follow up phone calls from the head of security and customer service, profusely apologizing and promising training for their staff. Ironically, we had been in their lobby a few day prior where she received a lot of smiles from staff just from being present.
How do I react to this? I’ve tried contacting a lawyer but they don’t seem interested. I contact the local representative of the AG’s office who referred my email to a staff member who I have never heard back from. I needed ER services that night and was refused only due to my service dog. I feel very discriminated against. Can anyone advise as to what course of actin I should follow. I never want this to happen to anyone else again and, since I live in farm country, this is the only hospital in the area. Thank you
Robin J. January 9, 2015
Assuming this is in the US, not on reservation land and not a VA facility, it’s probably covered by the ADA. In that case, you can file a complaint with the federal government:
If it’s on reservation land, you have to file the complaint with the tribal council. If it’s a VA facility, the complaint process is much more complex. (The VA is exempt from the ADA.)
Rene February 4, 2015
Hello, I want to start a program for a VA, I will not mention the location at this time, so Organizations/Volunteers may temporarily care for a Service animal if/when a Veteran must be hospitalized. I’ve been digging through Google searches, but have not yet found any similar programs that I may be able to borrow verbiage/ideas from, etc. Can you recommend any links which may be more fruitful. I have a Clt who signed himself out AMA when he really needed to be hospitalized, but has no one to care for his SD. Prior to my meeting with him, another staff member mentioned County Animal Control could keep him while he was hospitalized, but the Vet ws fearful that Animal Control might not return his SD or accdtly be put down, etc (I cannot really blame him for having those concerns- I would). I thought about contacting 1 of the Organizations that train SDs, but I imagine they would only foster dogs they had trained and this Vets SD was trained by the Vet ( SD completes many tasks for the Vet who is an amputee). Any recommendations would be greatly appreciated!
Anything Pawsable Staff February 7, 2015
Hi Rene! What a wonderful idea! Your best option is to contact your local VA hospital and ask to speak to someone in the Patients Relations Department, if they have one. They may be able to work with you to set up a program. Once you have one program in place at one hospital, and it’s working well, then you could consider expansion.
Jennifer April 11, 2015
I just took my mother’s SD to the public hospital where she is staying for pneumonia. She has been there for 3 days without him because I felt it would be best for my mother’s health while her immune system was compromised.
We took the necessary steps and even went beyond that by getting the treating doctor’s permission. I feel that I even went beyond what is required to protect other patients and staff. He was bathed and groomed the night before. He is also a hypoallergenic breed.
Even with all the time and effort we took I was still harassed by the hospital security as soon as I got there and had to be escorted by an officer to her floor. He is professionally trained, licensed and certified.
I showed the staff and security all of the information an gave them the SD statute# and the number to the federal protection office. Even after all this they still argued about the hospital policy.
After it was established that he was indeed a SD he was allowed to stay 15 minutes and we were told that her door had to be closed while we were there. He also had to be held the entire time which impeded his SD purpose and training. While holding him is ok in some cases is fine his training does require him to be able to be free to do his job when with her. Being held the entire time did confuse him. He is trained to detect seizures, heart attack and stroke’s and to warn and/or get help for her. He’s also part of her PTSD and depression treatment.
I feel that my mother’s and her SD’s rights were violated in this case.
Did I take the correct steps and what other steps should or would we be able to take to assure that this doesn’t happen again?
Amber June 22, 2015
Love this article! I’m just
Starting the battle of getting my daughters service dog back by her side
When she is in the hospital. After almost three years of multiple visits they came in this weekend and said he was no longer allowed with her. They are claiming it’s bc she has precautions. Can you please provide me the link more on modifying the policy? I need as much info as I can get. Thank you again.
Elise July 6, 2015
I spent time in the John Hopkins Seizure Ward in 2007. After getting my Medical Response service dog in 2008, and with his ability to detect seizures, I returned to the Ward at Thanksgiving time that year. Because my father stayed at a hotel very near by the hospital, and took the week off to spend most of the day, every day there with me, my service dog (age 2.5 at this time was both allowed to stay, and found it functional for him. He stayed the night with me as my father could take him out during the day and right before bed and in the morning (the Hospital was lenient with the visiting hours for my father so he could do this). This also worked out because of how low-key my dog is, and how he easily amused himself and did well with the smaller amount of exercise he was getting with my father. The icing on the cake, however, is that my seizure alert dog alerted to my seizures before anything showed up on all of the fancy monitors and thus showed the specialist at Hopkins what to look for. It was the catalyst that changed everything in my treatment and it couldn’t have happened if my service dog wasn’t able to be part of the process.
Since that stay in 2008, he has accompanied me to several ER visits, further lengthy stays at Jefferson Hospital, and a 10 day stay in our home hospital. Still, there are many factors to this. It is not for every person or every service dog – it is not even for every hospital stay. I have always had friends with me during the ER visits to help with him as I’ve be in a serious condition (though there were experiences at rural ERs where my friends had to show the ADA brief to the EMTs and explain that the dog WAS accompanying them inside with me). At Jefferson there have been friends and family to take him out, and he has had to spend a night or two with someone outside of the hospital due to logistics. The long stay in our local hospital is no more than 5 minutes from home and a very underused, uncrowded, quiet hospital with lots of friendly staff who often have plenty of time to get round to all their patients, and being so close to home there were loads of friends and family always coming and going to entertain him and take him out and about etc.
Also, I have ALWAYS had a private room. Never had I had to share a room, even with someone who liked dogs. My dog is, how should I say, uniquely lazy, and besides doing his job and tasks for it, needs VERY little distractions. He has trained an iron bladder from our travel in working internationally, and even now, at 9 years old, can usually go 16 hours between pee breaks.
So, success with hospitals, in my opinion, boils down to the help you have, the location/type of hospital area you are in, the experience and temperament of your dog, and how much they usually rely on making decisions about your care on their own in the outside world. There is, all so, unfortunately, the people you are working with at the hospital to consider. If you meet with your doctor/surgeon before hand, showing up with your service dog, talk about what he is for, they may be helpful in your intake process that you’ll be turning up and registering with a dog. I always have a sign on the door to my room that says “Service Dog in Room”, and usually if he is missing for some reason, the aid who’s come to take my BP, or the nurse to change my IV bag, or the doctor for the consult gets all droopy and sad, looks at the sign and goes “Where is he??”
The only other thing I can say is that, if it’s not a VA hospital, come armed with the ADA brief, go to, or call down to public/human relations, and if you believe that having your SD there with you is better for you (and you have the support system for it), then calmly show them the law. Ask them to consider your SD like a blind person’s cane, or an amputee’s prosthesis, someone with MDs wheelchair (because legally an SD is), and reassure them of the arrangements you’ve made for your dogs care (it won’t fall on staff, or hamper YOUR care). Show the policy of other hospitals from above, and calmly, but firmly ask them to support your disability as that is part of your total care.
Roymond November 14, 2015
I was hospitalized for hip replacement, and Bammer came with me. He was allowed everywhere right up to the moment I was rolled into the surgery, and was waiting when I came out. The hospital offered to have a volunteer look after him while I was in surgery, but I told them that as long as things were on schedule, a friend was showing up fifteen minutes before surgery to take him out for exercise.
He was quiet, and the entire staff found him well-behaved and very friendly when they asked if they could greet him. That came in handy when one night a nurse came in and he perked right up and growled. She backed out, I hit my buzzer and another nurse showed up, actually the supervisor. Since the supervisor had seen how well-behaved and friendly he had been, she decided that if Bammer was opposed to the new nurse it would be best to switch the schedule so another nurse came to my room. When the substitute nurse arrived, Bammer sat up, cocked his head, a gave a melodic little howl that generally means “I like you!”
I asked my surgeon about that when he came to check on me, and he said their policy is that the dog knows the master best, so they respect the service dog’s expertise as a fellow professional! That really blew me away. But it was true; one nurse who was “mine” ten hours a day also called him a “fellow health care worker” and looked for sings from him as to how I was doing.
At a different hospital, a staff person came charging out before I was hardly in the door and demanded certification papers and my diagnosis. She wasn’t interested in explanations at all. Bammer blocked her from stepping right up to me, which she didn’t appreciate, but it gave me time to pull out my phone and call the DoJ ADA number. Once I had someone on the line, I explained where I was and that someone didn’t understand the law, then handed the phone to this staff person and told her that due to my disability I couldn’t deal with her but here was someone who could answer all her questions. When she handed my phone back a bit later, she didn’t say anything but just stomped away.
On my next visit, I learned that the hospital had received a letter from the DoJ summarizing the incident and very firmly stating what was proper, and that the staff person in question had been reassigned to not have to deal with the public!
When my mom was in an Adventist hospital for heart surgery, I assisted her with registration, and Bammer helped me through that. We stayed with her right until her doctor came to look at the monitor they’d hooked her to and ordered them to change his schedule; he was taking her right in. He told me not to worry, and knelt down to tell Bammer everything would be okay!
When I got sleepy while waiting, a volunteer came by and asked if I’d like her to take Bammer for a walk or anything. That Adventist hospital trained many of its volunteers to help with service dogs if needed, which amazed me. I spent the night in the lounge, falling asleep, and learned the next day that one of the volunteers checked on Bammer at least once an hour while letting me just sleep.
So… some hospitals still haven’t figured it out, but others have gone beyond what’s required to not just accommodate but be helpful with service dogs.
PINGBACK: Service Dogs: Ethics and Education Part Two—Certification, or Common Sense? - The IAABC JournalThe IAABC Journal | The International Association of Animal Behavior Consultants September 30, 2016
PINGBACK: Service Dogs: Ethics and Education Part Two—Certification, or Common Sense? | The IAABC Journal - Fall 2016 December 24, 2016
Elizabeth April 22, 2017
When my service dog is with me for a hospital it’s because I’m so sick I need him. Yesterday I was in the ER at the VA because I was seizing back to back. Instead of letting him go up to ICU with me they were trying to get animal control to take him to the pound. They put me on a hold so I couldn’t leave AMA but still insisted he had to leave. They stressed me into more seizures. He was the only one watching out for me. Every time I started seizing he would bark or whine to get a nurses attention and then they’d come give me medicine. To have been without him would’ve been detrimental to my health. I don’t understand how having hospital volunteers or staff on break take him outside 4-6x/day would’ve been such an unreasonable accommodation.
MIKE HONCHO May 28, 2017
IF YOU READ THE ARTICLE . ITS NOT THE HOSPITAL STAFF RESPONSIBILITY TO CARE FOR YOUR SD.
Marisa Mullins October 4, 2017
Is it legal for hospital staff to ask directly to see the certification for a service dog?
Heather October 10, 2017
im looking for more information on service dog teams in er’s. today my husband went to a hospital on an army base and we were told that it is against hospital policy for his service dog to be admitted into the er due to hygiene and the possibility of other patients being allergic. i have been told by several people who know more about hospital and rules than i do and i was told that this hospital was in direct violation of ada laws
Caitlin Williams October 23, 2017
Only one things is see wrong with this. Service dogs are in fact ALLOWED in maternity wards
Rocio November 19, 2017
Hi my name is rocio and i have a question how can i get a service dog for my daughter she’s autistic and has another syndrome and shes very non verbal thank you so much
Arlene Yates November 19, 2017
Is it legal for hospital staff to denie a certified emotional support dog access when it is to accompany it’s owner when sitting with a patient who is not certified?
stacy whitney January 11, 2018
I just had a bad experience at the ER with my service dog. She is very well behaved and even spent 5 days with me in a hospital after I had a heart attack. I have had seizures since i was 9 years old. Recently, I was at home and had 4 back to back seizures at home. My neighbor called 911. Admittedly, I was “out of it” . My adult son and my service dog rode in thee ambulance with me. By the time we got to the hospital, I was coming round better and better able to respond. When we entered the ER, staff stopped us stating that my dog could not enter the hospital. It was against hospital policy. They said that a seizure assistance dog was not a service dog, and that even if it was, they could still deny access. The EMT’s were upset over it, my son was upset, and I was very distraught. I had to sign an AMA to get out of there and go to another nearby hospital that would allow my dog. The first hospital is now changing their story. They said the dog was presented to them and a therapy dog, that they had no idea the dog was coming, and that they would never deny access to a service dog. I have the EMT team that was with me that disputes all these statements, as well as two other EMT teams that were witnesses, and the EMT’s supervisor that has the hospital on a recorded line, informing them I was coming with my dog. My dog was a trooper. Through all the chaos, she was calm..even when they put a gurney net to mine that had a psychiatric patient who was accompanied by a police officer. the woman was screaming, yelling, and trying to throw punches at anyone near her. my dog moved once, and it was so she could move further up on my gurney for her comfort. She then laid still.