The Planted RVT Pet Sitting Information Form
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Owner Information
Name
*
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
What dates will you need me?
Pet Information
Tell me about your animal(s)
Pet 1: name, age, species, and breed
*
Pet 2: name, age, species, and breed
Pet 3: name, age, species, and breed
Pet 4: name, age, species, and breed
Pet 5: name, age, species, and breed
Care Needs
Does your dog have any medical problems (seizures, painful conditions, etc.)?
*
Yes
No
If yes, please list them and explain any accommodations or support I should provide them.
Is your pet on any medications that I will need to administer?
*
Yes
No
If yes, please provide the medication(s), dose, and when and how to administer
What is your pet's feeding schedule, and routine? (please include food type, quantity and any additional instructions)
*
Please list any food restriction or known allergies
*
Where does your pet sleep?
*
Where does your pet stay when you are not at home?
*
If your pet needs to be crated or confined, how do they react?
*
Please describe your pet's exercise needs
*
Does your pert have any of the following behavior concerns (check all that apply)
*
Fear or reactivity to strangers
Fear or reactivity to animals (outside or on leash)
Resource guarding or aggression around food, places, or objects
Escape behaviors (from confinement, or property)
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?
Describe a typical 24 hour day for your pet(s)?
Are there any other tasks you need me to do (ie. watering plants, putting out trash bins)
Are there cameras in the home? If so, where?
WiFi password
Do you have an alarm system?
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 the event of an emergency requiring veterinary care? (see emergency policy below for more information)
*
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?
*
Primary Veterinarian's Phone Number
*
Please enter a valid phone number.
Primary Veterinarian's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Secondary Contact: In the event that you cannot be reached, Is there someone I can contact for additional support?
*
First Name
Last Name
Secondary Contact Phone Number
*
Please enter a valid phone number.
Relationship to you
*
Do we have your permission to share adorable photos of your pet on our website or social media? We love showing off our furry (or scaly, or feathery!) friends. Only the cutest shots—we promise! (Yes or No)
*
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