Booking Form : Contact Details

The Four Paws Agency

11 Campion Gardens, Birmingham, B24 0HF 07803 161268 | will@thefourpawsagency.co.uk www.thefourpawsagency.co.uk
Please read this form and the accompanying Terms and Conditions carefully (this level of detail is required to ensure we can provide the highest level of care and safety for your Dog). Then complete and sign this electronic form (including acceptance of the Terms and Conditions, Off the lead Consent Form and Waiver of Liability).
Please note your data is safe and this form is fully compliant with GDPR regulations. We will not use or sell your data in any means other than for The Four Paws Agency to contact you and provide a service for your pet.
Your Details *

First Name Last Name
Home Address *

Street Address

Street Address Line 2

City County

Post Code
Gate Codes / Alarm Instructions
Phone Numbers *

Landline Mobile
Email *
example@example.com
Vet Contact

Street Address

Street Address Line 2

City County

Postcode
Vet Phone Number

Landline Mobile / Email
Holiday Contact

Street Address

Street Address Line 2

City County

Postcode
Holiday Phone Number

Area Code Phone Number
Number of Pets? *
Name of Pet(s)? *
Are your Pet(s) vaccinations up-to-date? *
Have your Dog(s) been vaccinated against Kennel Cough? *
Which service do you require? *
a) Dog Walking b) Garden/Home Visit c) Dog/Pet Sitting d) Cat/Small Animal Feeding/Visits e) Overnight Sitting in your Home
Please specify the dates you wish your Pet(s) to be cared for? If ongoing please type that *

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Booking Form : Dogs Part 1

Dogs
Sex: *

Male Female
Insured
Microchipped
Spayed or Neutered: *

Yes No No - my pet is too young at the time of completetion Not applicable due to the species of my pet.
Does your Dog show any aggression? (i.e, towards other dogs, children, over food or toys etc) *
If Yes please specify above
Would you prefer The Four Paws Agency to walk your Dog on or off lead in parks, fields or woodlands? *
* Please note : The Four Paws Agency will not walk your Dog off the lead anywhere in or around any roads or side roads under any circumstances.
Is your Dog scared of anything? (i.e. traffic, loud noises, thunderstorms, fireworks etc) *
If Yes please specify above

Booking form : Dogs part 2

Dogs
How old is your Dog? *
What breed is your Dog? *
What colour is your Dog?
Is your Dog a rescue? *
If Yes do you know their background?
How long have you owned your Dog? *
Does your Dog have any medical issues? *
Has your Dog been ill in the last 30 days? *
If Yes did you consult a Vet and please give a brief description of the illness
Is your Dog currently taking any medication? *
If Yes please specify and any instructions if you require us to administer
Please indicate if your Dog has any sensitive areas on his/her body? *
Please describe any restrictions on your Dog's activity (e.g. due to physical limitations such as hip dysplasia) *
Is your Dog trained? *
Please indicate what level : Not trained / Knows basic commands / Well trained / Extremely well trained / Trained by yourself (Please describe level of training)
How does your Dog walk on a lead, and do they behave differently when off lead? *
Badly (pulls) / Fairly Good (pulls a bit when excited) / Good (Doesn't pull hardly) Very Good (doesn't pull at all / walks to heel)
Does your Dog live with children?
How does your Dog behave around new children?
How does your Dog behave around livestock?
How does your dog react to other people and Dogs when on walks, both on lead and off lead? *
Please describe general behaviour and energy levels (both inside and when out) *
Has your Dog ever jumped on someone? *
If Yes please describe the circumstances
Has your Dog growled or snarled at someone? *
If Yes please describe the circumstances
Please provide details if your Dog is anxious around, or frightened by, any of the following? *
Noises / Breeds of types of Dog / Types of People / Other
Where does your Dog sit when travelling in the Car? *
Does your Dog get car sick? *
Does your Dog have a specific command to "go to the bathroom"? *
Has your Dog ever been in a fight or bitten another Dog or Person? *
If Yes please describe the event / other than play biting :
Does your Dog allow you to take things out of his/her mouth? *
What type of Dogs does your Dog prefer to socialise with?
e.g. small, females, playful, calm etc
Will chase? *
Doesn't chase / Cats / Deer / Livestock / Small Animals
Off lead with owner? *
Yes - Always / Usually / Occasionally / Never
Recall *
Very good / Average / Poor /
Type of lead
Standard / Extendable
Type of Restraint
Full Check / Half Check / Standard Collar / Gentle Leader / Halter / Harness / Muzzle / Other please specify
Has your dog escaped or tried to escape by digging, jumping etc? *
If Yes please explain :
Is your Dog destructive? *
If Yes please explain :
Does your Dog have any allergies or anything to avoid? *
Is your Dog crate trained?
Does your Dog suffer from separation anxiety?
If Yes please explain to what extent :
Where do you keep your pet's leash and/or collar, Harness and towel? *
Please speficy the type of water your provide for your pet.

Tap Filtered from refridgerator dispenser Filtered from pitcher in refridgerator Filtered from sink Bottled
Location of water dish
Water dishes will be refilled at each visit and cleaned 1x per day.
Is your pet restricted to a certain amount of water?

Yes No
Please inidicate how much water to provide at each refill
Special instructions for water
If this question does not apply to your pet please type N/A.
Does your pet receive treats? *

Yes No
Please indicate how many treats your pet can recieve PER VISIT. *

1/2 to 1 treat 1-2 treats 3-4 treats No limit
Location where treats are stored *
If this question does not apply to your pet please type N/A.
When does your pet receive their treat? *
Does your pet have a special routine to follow before getting a treat? *
Does your pet require any of the following when receiving a treat? *

give treats apart from other pets Supervise while eating treat Remove treat after so much time Dispose of uneaten treat Not Applicable
Special instructions for treats *
Does your pet receive medications? No need to include monthly preventative medications. *

Yes No
Medication #1
Location where Medication is stored
Medication times
Directions
Additional Information
If this question does not apply to your pet please type N/A.
If your pet has more than one medications please list the additional medications and instructions here.
Where should we dispose of all pet waste? *
Please let us know what games and or activities your pet likes to play and/or do.

Belly Rubs Cuddle Give kisses Fetch Tug-o-war Chase Walk Run/Jog Play with toys My pet does NOT play games or activities
Does your pet play with toys?

Yes No
Location of toys:
Favorite Toys:
Please list the commands and words your pet knows, should know, or ones that you would like them to know.

My pet does not know any commands or words Sit Stay No Come or Come Here Outside or Go Outside Go Poop Go Potty or Go Pee Do your business Bad or Bad Dog/Cat Go in the House Down or Get Down Off Walk or Let's go for a walk Food Treat Are you hungry? Do you want to eat? Who is here? Who is at the door? Good or Good Dog/Cat Move or Move over Ride or Do you want to go for a ride? Lay Down Don't Pull of No Pull Cookie Drop It Slow Down Heel Walk Nice Naughty Don't Touch Leave it
Is you pet crated or placed in a restricted area when no one is home?

Yes No
Location of crate, gated off area, or fenced in garden
Please type N/A if this question does not apply.
Please let us know which of the following does your pet NOT like.

Baths Hot Days Sharing Food Dishes People or other pets near food dish People or other pets near treats Nail trims Rain Cold Loud Noise Vacuum Thunder Petting Hind End Petting near the head New or Strange Animals Humans Touching Ears Touching Feet Other family pets Strangers Fragrance Sprays None of the above
Please let us know how your pet reacts to any of the above.
If this question does not apply to your pet please type N/A.
Has your pet ever done any of the following? *

Attacked and/or bit someone Attacked and/or bit another animal Escaped from home Injured self out of boredom/fear Not Applicable
Please describe the incident(s) even if mild or under extreme or unusual circumstances
If this question does not apply to your pet please type N/A.
Where does your pet like to escape or hide?

Hides behind or under bed Hides behind or under couch Hides under tables Hides in closets Runs out doors Runs upstairs Not Applicable
Please indicate how your pet can retrieved.
If this question does not apply to your pet please type N/A.
Does your pet have any ongoing or reoccurring known illnesses and/or injuries? Is your pet undergoing any medical treatments? *

Yes No
If yes please explain in detail.
Did your pet have a previous illness or injury we should be aware of? *

Yes No Unknown
If yes please explain in detail.
Has your pet been diagnosed with allergies? *

Yes No
If yes please list what type pf allergies below.
What type of symptoms does your pet exhibit when their allergies flare up? *
Please let us know what temperament and personality describes your pet. Check all that apply.

Calm Sweet Loving Cuddly Agressive Hyper Shy Scared Timid Relaxed Easy Going Pushy Suspicous Aloof Fearful Lazy Jealous Trusting Spiteful Crazy
Please describe pick up and return routine
Please give any other information that you think would be useful to enable us to give your Dog the best possible care while under the care of The Four Paws Agency
This form was prepared by: *

First Name Last Name
Date *

Month Day Year Hour Minutes AM/PM Option
Please use your mouse or finger to sign each section below. If you don't agree please type No. Thank you
Key Holder Disclaimer & Waiver of Liability:

The information I have given in this application is true, correct and complete to the best of my knowledge. I have read and agree to abide by the Terms & Conditions for services received from The Four Paws Agency. I understand that this form acts as permission to hold keys to my property, which I have or will provide willingly. I hereby indemnify The Four Paws Agency and their staff against liability of any kind whatsoever arising from damage or loss of any property.
Signed *

Clear
Off the Lead Consent Form :

I agree to The Four Paws Agency having the right to allow my Dog off the lead and understand that all terms and conditions remain the same:
Signed *

Clear
Disclaimer & Waiver of Liability:

The information I have given on this application is true, correct and complete to the best of my knowledge.

I have read and agree to abide by the Terms and Conditions for services received from The Four Paws Agency. I hereby indemnify The Four Paws Agency and their staff against liability of any kind whatsoever arising from my Dog's participation in any services offered by The Four Paws Agency.
Signed *

Clear
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The Four Paws Agency

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Booking Form : Dogs Part 1

Booking form : Dogs part 2