Customer Details
Bird Care & Sitting
**PLEASE EMAIL WOOF@ITSCAHRIS.COM OR CALL 0421 474 692 TO DISCUSS DATES PRIOR TO COMPLETING THIS FORM, THANK YOU**
Your Name
*
First Name
Last Name
Bird(s) Name
Pet 1
Pet 2
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mobile Number
*
E-mail
*
example@example.com
Local Emergency Contact Details
*
Full Name
Mobile Number
Relationship to you
How did you hear about us?
*
Please Select
Newspaper
Google
Instagram
Facebook
Market Stall
Flyer/Brochure
Business Card
Magazine
Car Advertising
Friend/Other Business (Please specify below in box)
What friend/business referred you?
Do you or your pet have an Instagram Account? If so please put the handle name here:
Bird Details:
Breed:
Pet 1
Breed:
Pet 2
Age & Date Of Birth:
Pet 1
Age & Date Of Birth:
Pet 2
Sex Pet 1:
Male
Female
Unsure
Sex Pet 2:
Male
Female
Unsure
Is Your Bird/s Frightened of anything? eg. Loud noises, new people, other animals, thunder etc.
Please add details for Pet 1 & Pet 2
Does your bird have any bad habits? eg. Chewing household goods, flying away, biting humans, large amounts of squawking, food guarding etc.
Is your/s bird Ok with:
Water? Eg. Misting spray, cage bird baths
Travelling in the car
Travelling in a carrier/travel cage
Other domestic birds
Human interaction eg. Sitting on shoulder/ finger
If there is anything you'd like to add to the above, please specify in detail here. The more information the better.
Are there any sensitive areas on your bird that needs to be known? Eg. claws hate being touched, doesn't like head being scratched, sore wing
Please answer for Pet 1 & 2
Is your bird/s currently on medication? If so what for and would you like me to administer?
Please answer for Pet 1 & 2
Does your bird/s have any allergies? Eg. Environmental/ Food
Please answer for Pet 1 & 2
Has your bird shown any signs of the following in the past 14 days:
Feather Fluffing
Coughing/Sneezing
Tail Bobbing
Loss of appetite
What commands does your bird know eg. Hello, how are you, wolf whistle, any songs?
Please answer for Pet 1 & 2
Please provide details of your bird's meal plan. You are to provide your bird's seed & medication. We will take care of the fresh fruit & veggies.
Eg. 1 scoop, once per day
What duration is your bird out of their cage at any one time
30 minutes
60 minutes
120 minutes
More then 120 minutes at any one time
Vet Details:
Vet Business Name and Street Address
Suburb
State
Postcode
Phone Number
Is Your Bird Insured?
Yes
No
Microchipped
ID Tagged
What access will be given to enter your property to collect your bird/s? *If applicable*
Front Door Key
Side Gate Key
Back Door Key
Garage Remote
Lock Box Code
Alarm Code
Someone will always be home when you come
Where will your bird/s be kept at your home? *If applicable*
Eg. Kitchen bench, front door, backyard
Please explain where/how I can access your property for the return of your pet and where you'd like me to leave your pet. *If applicable*
Explain as much as possible
Is there anything else we need to know?
Please answer for Pet 1 & 2
Please verify that you are human
*
My Products
*
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Bird Care
Daily Rate
$
25.00
AUD
How many days in care including pick up and drop off days
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Item subtotal:
$
0.00
AUD
Bird Care For Over 30 days
Daily Discounted Rate
$
20.00
AUD
How many days of care are required, including pick up and drop off days? Minimum 30 days
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Cage Hire
Daily Rate
$
5.00
AUD
Amount of days for cage hire
0
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Credit Card
Submit
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