| * Required fields |
| Name *
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| E-mail Address *
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| Your address at home: * |
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| Home Phone * |
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| Cell phone |
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| Work phone: * |
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| Your Pet(s) Name |
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| Pet(s) age and breed * |
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| Weight of pet(s) * |
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| Your pet is... * |
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| Name of your vet doctor: * |
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| Your vet's phone number: * |
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| The street address of your Vet's office: |
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| Your prefered emergency vet: |
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| Is you pet current on his/her vaccinations? * |
Yes
No
Rabies only
I'm Unsure
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| Please describe your pets medical history, including specifically, any history of medications, surgeries or allergies * |
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| Please tell us about any medications, vitamins or supplements your pet is currenlty taking. Please include brand name, dosage amount in milligrams or ounces, and the location in which the meds are kept in your home. be as specific as possible. * |
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| If we had an emergency with the home or pet and could not reach you, who would you like us to call for major decisions? |
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| Your Emergency contact's home phone number: * |
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| Emergency Contact's Cell Phone Number |
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| Emergency Contact's Home Address: * |
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| Does your pet have current id tags on with your CURRENT address AND CURRENT PHONE? * |
Yes
No- needs new tags
phone is current but not address
address is current but not phone
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| How often, in the last 2 years, has your pet been left in the care of a pet sitter? * |
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| Please tell us how your past petsitting experiences have gone? Positive? Negative? How has your pet reacted? |
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| How did you come to aquire your pet(s) * |
Purchase
Adoption
Inherited
Gift
Other
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| How old was your pet when s/he became a member of your home? * |
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| Do you expect your pet to have any separation anxiety? * |
Yes
No
Not much
Unsure
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| has your pet ever run away, gotten out of the backyard or otherwise disappeared from your home for more than 15 minutes? * |
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| Do you anticipate that your pet will try to get out or otherwise escape our care if given the opportunity? * |
Yes - S/he's a Houdini! keep the pet in home or on leash at all times.
Maybe, if i am not around
No - s/he never leaves the house/yard even if off leash or door is left open
I'm unsure - s/he's never been given the chance before!
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| Please describe for us any preventatives we should use to keep your pets safely in your home or on your property while your away. * |
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| Describe any agressive or assertive behavior your pet may have toward other animals or people: * |
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| Feeding Times * |
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| Check here if you'd like us to walk your dog after we feed him/her
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| Check here if you'd like us to walk your dog before we feed him/her.
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| Check here if your pet receives medication with food.
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| describe to us how your pet shows affection to people and animals: |
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| Tell us about your pet's favorite games and toys: * |
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| How does your pet communicate his/her needs and wants to you? how do you know if your pet is feeling unwell or has to go out? * |
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| Could your pet pose a threat to our sitter? * |
Yes
No
Unsure
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| describe any fears your pet may have (thunder, lightening, hats, objects, motions, sounds) * |
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| Has your pet gone to the bathroom in the home before? * |
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| Where do you keep a clean up solution for accidents? * |
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| Normal bathroom activity for your pet is: * |
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| Please share with us anything else you feel we should know about your pet, or the way in which you would like him/her cared for: |
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| Do you agree to our terms and conditions located in our Privacy Policy link below? * |
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| Will anyone else have access to your home/pet when we pet sit for you? * * |
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