Client Intake Form
Your Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Address
*
Street Address
City
Province
Postal
Emergency Contact Information
*
Pet Information
Please provide information regarding your pet(s) to be walked
*
Please provide further information regarding your pets (allergies, behaviour, habits, phobias etc.)
Which service are you choosing? (excludes HST)
15 Min Private Walk /$15
30 Min Private Walk / $21
60 Min Private Walk / $32
50 Min Off Leash Adventure / $26
Successful Puppy Package / $40
Other
Which days are you looking for walks?
Monday through Fridays
1-4 SPECIFIC days a week (enter days below)
1 - 3 days, but flexible on which days
Less than 6 walks a month
Enter specific days if applicable
Veterinary Information
Veterinary Clinic
*
Clinic Address
*
Street Address
City
Phone Number
Please enter a valid phone number.
Back
Next
I allow Heidi's Happy Hounds to take my dog off leash. (Applies only to our Off Leash Adventure clients, otherwise check NO)
*
Yes
No
Signature
Submit
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