GUIDELINES FOR THE CARE OF A PET IN A CARE HOME Form-0039
The following information must be provided from the resident/family/representative during initial consultation with Skymac.
Resident's Name:
First Name
Last Name
Type of pet:
Pet's Name:
Feeding routine
Sleeping habits
Other known behaviours/habits
Information regarding past/present veterinary checks
History of worming and flea prevention procedures
What is to happen to pet if it dies?
What is to happen to pet if owner dies first?
What is to happen if the owner moves from the home on a permanent basis?
Care Manager to complete checklist below once each item has been discussed with the resident/family/representative.
Understanding and agreeing that the pet may have to be removed from the home if it has a negative impact on other services users or staff
Acknowledgement that Skymac has final say regarding the accommodation of the pet
That the owner of the pet either subscribes to an Insurance Scheme which ensures payment of veterinary fees or that they pay for all costs associated with the care of the pet
Any cost incurred by the home as a result of damage caused by the pet should be met by the resident or relatives. Provision of food and other items such as lead, bedding, litter tray and regular supply of litter, or sanded sheets for caged birds etc
Ideally dogs or cats should be neutered before coming into the home
Agreement from other affected residents
All cost implications of maintaining the pet and that these must be met by the resident/family or representative
All transport to and from the vet for treatment will be undertaken by the family/representative
Circumstances where the resident is unable to fully understand this agreement the family/representative must agree to take full responsibility in abiding by this agreement and acting on their behalf
Acknowledgement and Agreement
By signing below, I acknowledge and agree to the above.
Resident's Name:
First Name
Last Name
Signature:
Date:
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Day
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Month
Year
Date
Guardian/Family Member Name:
First Name
Last Name
Signature:
Date:
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Day
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Month
Year
Date
Witness Name:
First Name
Last Name
Signature:
Date:
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Day
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Month
Year
Date
Care Manager Name:
First Name
Last Name
Signature:
Date:
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Day
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Month
Year
Date
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