Vet Nurse Services Pet Minding Form

Welcome to Veterinary Nurse Services! Please complete this form for our records.

Full Name (s)

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Phone

Cell Phone

Email Address

example@example.com

(by adding your email address, you accept correspondence by email)

Pets Name

Species

Breed

Sex

Desexed?

Age or date of birth:

Microchip number (if known)

Please add any more pets here: (include details as above)

Please list any known medical conditions your pet has, and medication they are on:

Current Veterinarian and Clinic:

Do you give permission for vet nurse services to correspond with your veterinarian if needed?

In case of emergency, do you give permission for Vet Nurse Services to seek treatment by your vet or an alternative if this one is unavailable?

(we will endeavour to contact you first).

These questions (while extensive) will help us to care for your pet, whilst you are away based on their needs. Our primary concern is the safety and health of your pet, and primary goal is to improve their wellness through health, comfort and enrichment.

Dates pet minding requested: From

Date

To

Date

Once or twice a day? (Please also state early or late morning, early or late afternoon, or evening. We will do our best to accommodate.)

Access to the property and location of keys or lights etc

Alarm details? (feel free to leave security details blank and update Vet Nurse Services by phone.)

Location of lights if tucked away. Any equipment, food, toys, litter or cleaning products that may be needed

Is your pet contained in the house, or able to enter and exit the property?

We charge no extra for cleaning litter trays!

We also recommend cats to be kept indoors whilst you are away if this is possible. This prevents wandering behaviours and minimises injury or accidents. Also ensuring that we can view and monitor health, eating, toileting and demeanour of your cat.

Any other services: would you like mail cleared, plants watered, or lights turned on/off

What is your pet's main diet and favourite treats (list any food restrictions) Where is this kept.

Is your pet a fussy or eater, a grazer, or a scoffer?

Does your pet require any flea/worm treatment whilst you are away?

Medical history, illnesses, concerns:

Please confirm what medications we will be giving whilst you are away:

What are your pet's normal activities. Any unusual behaviours? (So we are not worried!) Please describe your pet's personality, idiosyncrasies, compulsive behaviours, concerns or quirks! Does your pet have a favourite toy or calming aid?

Does your pet have any known fears or phobias?

Does your pet have any known allergies or medication sensitivities?

Any special requests while we visit? (Physio, play time, cuddles, grooming).

Where is your pet's favourite place to hide?

Is it ok for photos of your pet to be shared on social media or our website?

Would you like to receive photos or text message updates while you are away?

Is there anything else you would like to add or request?

Declaration

I declare that the information I have provided is true and accurate.I have read the terms and conditions and agree to them. (Below)I wish to proceed to enlist the MINDER services of Veterinary Nurse Services Limited

Signed Owner/Guardian

Date

By signing this form, you acknowledge that you are the legal guardian or owner, and the information you have given is accurate and true to your knowledge. In the case of emergency or sudden illness, you consent to the treatment given as necessary by your veterinarian stated above, or a more appropriate located veterinarian if needed.

In return, we agree to provide your pet with the best care we are able to, using vet nurse experience to make the right choices for their welfare. We aim to provide a nurturing, fun, and stimulating service that promotes mental, emotional and physical health.

The utmost care will be given in caring for your pet, but due to the unpredictability of animals, we cannot accept responsibility or liability for any damage to the pet other than in the circumstance of wilful neglect. Examples include (but are not limited to): bites, injury, disappearance, illness, and death.

You understand Vet Nurse Services may need to obtain your pet's previous medical history.

Vet Nurse Services are able to provide medical/emergency treatment for your pet if needed and can seek veterinary attention. Attempts will be made to contact you, but if you cannot be reached, Vet Nurse Services can make decisions regarding their care.

Should any additional costs be incurred, you will be invoiced at the conclusion of the contract. Examples include (but are not limited to): mileage for vet appointments and purchase of pet food, toiletries etc.

Vet Nurse Services reserves the right to terminate this contract at any time before or during its term if Vet Nurse Services determines the pet poses a health and/or safety risk and the concerns prohibit the nurse from caring for the pet, or that the animal requires health care by a veterinarian. The client will be contacted and responsible for making alternative arrangements. If non-contactable, the pet will be placed in a kennel/cattery or veterinary hospital.

You agree to notify Vet Nurse Services of any concerns within 48 hours of the homestay end date. Any concerns beyond this time will not be considered.

Vet Nurse Services Pet Minding Form

About the house:

About your pet: