Golda’s Happy Paws
Dog Sitting, Client Info and Emergency Contact
Owner Information
Name
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First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
While I am out of town, I prefer to be contacted by
Please Select
Phone Call
Text
Email
How did you find Golda’s Happy Paws?
*
Pet Information
Tell me about your animal(s)
Pet 1: name, age & sex, species, and breed
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Pet 2: name, age & sex, species, and breed
Pet 3: name, age & sex, species, and breed
Pet 4: name, age & sex, species, and breed
Pet 5: name, age & sex, species, and breed
Care Needs
Which services are you interested in?
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Dog Training
Dog Walking
Dog Sitting
In-Home Overnights
Short Term Boarding at Golda's
Cat Sitting
Other
How often are potty breaks needed? How many hours does your dog regularly go between potty breaks?
Please describe your pet's daily exercise needs
*
Does your pet have any of the following behavior concerns (check all that apply)
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Jumping on guests
Pulling on the leash
Fear or reactivity to strangers
Fear or reactivity to animals (outside or on leash)
Resource guarding or aggression around food, places, or objects
Bite History
Escape behaviors (from confinement, or property)
None of the above
Other
Please describe in more detail the behaviors you selected above, and how you manage them.
Any other behavioral quirks or concerns I should be aware of?
Does your dog have any medical problems (seizures, arthritis, etc.)?
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Yes
No
If yes, please list and explain any accommodations or support needed
Is your pet on any medications that I will need to administer?
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Yes
No
If yes, please provide the medication(s), dose, and routine
Please list any food restrictions, intolerances, or known allergies
*
What is your pet's feeding schedule, and routine? (please include quantity and any additional instructions)
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Where does your pet sleep?
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Where does your dog sleep at night?
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Where does your dog stay when you are not at home? Is your dog crate trained?
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Are there any other tasks you need me to do (ie. watering plants, putting out trash bins)
Emergency Contacts and Vet Information
In the unlikely event of an emergency, I will use need this information to be correct and up to date.
What should I do in the event of an emergency requiring veterinary care? (see emergency policy below for more information)
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Contact me first
Seek immediate veterinary attention
Contact my secondary contact first
What is the best phone number to reach you at, in case of an emergency?
*
Please enter a valid phone number.
What is the name of your primary Vet or Vet Clinic?
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Primary Veterinarian's Phone Number
*
Please enter a valid phone number.
Primary Veterinarian's Address
*
Street Address
City
State / Province
Zip Code
Does your primary veterinarian have 24h emergency hours?
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Yes
No
Secondary Contact: In the event that you cannot be reached, Is there someone I can contact for additional support?
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First Name
Last Name
Secondary Contact Phone Number
*
Please enter a valid phone number.
Relationship to you
*
Policies Acknowledgments
Golda’s Happy Paws and Sitters will endeavor to create as safe an environment as possible for the care and training of my animal(s) and will offer only sound, safe, and responsible training and training instructions. However, I recognize that Golda’s Happy Paws is not responsible for any unintentional errors, omissions, or incorrect assertions. I understand that the recommendation of any other product or service is not a guarantee of my satisfaction with that product or service. Further, I am and will remain responsible for the actions of my animal(s) at all times and I hereby agree to indemnify and hold harmless Golda’s Happy Paws of any and all claims of injury, expense, costs, or damages caused by the actions of my animal(s) while under Golda’s Happy Paws care, instruction or control and under my own care as a result of following training instructions. I have been told by Golda’s Happy Paws and understand the inherent risks of owning an animal(s) , including but not limited to the risk of animal bites to myself or others. Emergency Care: In the event that I cannot be reached, Golda’s Happy Paws has my permission to react to a situation as she deems appropriate, and or necessary for the health and safety of my animal(s), herself, or others, and that I am responsible for compensating Golda’s Happy Paws for any monetary charges made for items and or services including but not limited to, vet bills, pet food, or human medical attention. Cancellation Policy: We appreciate cancellation notice as far in advance as possible. To avoid being charged, a 24-hour notice is required. Cancellations within the 24-hour window result in “last minute cancellation fee”, according to current policies. Exceptions will be addressed on a case by case basis. By checking the box below, I agree to and accept the above policies.
*
I agree and acknowledge
Signature
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