Client Intake Form

Client Intake Form
Pet(s) Parent Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number
Format: (000) 000-0000.
Email
Medical Information
Veterinary Clinic/Hospital
Veterinary Address

Street Address

Street Address Line 2

CityState

Zip Code
Veterinary Phone Number
Format: (000) 000-0000.
Previous/Ongoing Illnesses/Injuries/Diagnoses of Your Pet
My pet(s) has/have no ongoing injuries, illnesses, or previous diagnoses.
Medications
My pet(s) is/are not taking medications.Please let us know the name(s), time(s), and dosage(s)
Allergies:
My pet(s) has/have no known allergies.
Pet(s) Information

Number of Pets

Rows	1	2	3	Other
Dogs
Cats
Other

Pet(s) Name(s)
Please provide name(s) for all pets, kind of pet(s), breed (for dogs), and age.
Favorite Toys or Games
Fears
Emergency Contact
If you have a person in the city that could help in case of an emergency, please list their name and phone number here. If none, you can skip this question.
In case of an emergency, do we have your permission to take your pet to the vet and start treatment even if we can not reach you prior to doing so? If you answer "Yes", we recommend you have a payment method on file and a signed consent for treatment with your vet.

Other
Dog(s) friendly with other dogs? If "Other" please explain

Other
Dog(s) friendly with people? If "Other" please explain

Other
While walking your dog(s), do they tend to look for things to eat off the ground? If "Other" please explain

Other
If you answered "Yes" in the previous question, would your dog try to bite if we try reaching into your dog's mouth to remove the object? If "Other" please explain. You can also use that space to include instructions on how to safely remove items from your dog's mouth.

Other
Can we take your dog(s) to the dog park? If "Other" please explain

Other
Are your pets spayed/neutered?

Other
Are your pets' vaccines up to date?

Other
Can your pet(s) get treats?

Other
When coming over for walks/visits, how would you like us to distribute the time?

Other
While at your home, is there anything else you would need us to do during our visit? (food, medications, bringing mail in, water plants etc.)
We'll try to accommodate any reasonable requests.
House Sitting Care Instructions

If you are not interested on this service you can skip the following questions. However, if you are, please answer as many questions as possible so we can take care of your pets in the best way possible.
Feeding Schedule and Instructions
Please let us know the times, kind of food (e.g. wet or dry, if applicable), and amount that your pets should get. Also, please indicate if there's something special we should know when feeding your pets; e.g. Fido needs to get a capsule of probiotics sprinkled on his food and 2 pumps of fish oil.
Dog Walks
Please indicate number of walks, time of the day, and duration of a typical walk for your dog(s). The base price includes 90 minutes of walking per day; charges for additional walking time may apply.
Where do(es) your dog(s) usually sleep(s) at night?
For how long can your pet(s) be left alone?
While house sitting, we strive to spend as much time as possible with your pets. However, if we need to leave your house we want to do so in a safe way for your pets.
During house sitting stays, how often would you like us to provide updates about your pet(s) or get in contact with you?

Other
Additional tasks (If you answered this question above, please skip it)
Please let us know if there's something else you would like us to do during our visit such as bringing mail in, watering plants, checking for packages, etc.
Is there anything else we haven't asked that is important or you think it would be useful for us to know? If so, please let us know below.
Upload Care Instructions

If you already have detailed written instructions, you can upload them here.
Cancelof
Care Instructions Online
If you already have detailed written instructions somewhere on the web (Google Docs, Dropbox, OneDrive, etc) please paste the link in the space above.
Thank you!
Thank you very much for taking the time to fill out this questionnaire; it will helps us greatly to make sure your pet(s) get the best care possible!

There's nothing else you need to do at the moment. With the information you provided we'll create a profile for you and your pet(s) on our database. Please feel free to send a request using this other form (https://bit.ly/BetoPetsRequest) whenever you need services.
Should be Empty:

Client Intake Form

Medical Information

Pet(s) Information

House Sitting Care Instructions

Thank you!