Wags & Kisses Pet Sitting Intake and Emergency Contact Form Template

Pet Sitting Intake and Emergency Contact Form Template

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Fur Baby Parents Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
While I am out of town, I prefer to be contacted by
What dates will you need me?
Please include the time you will be returning home.
Fur Baby 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 fur baby have any medical problems (seizures, painful conditions, etc.)?*

YesNo
If yes, please list them and explain any accommodations or support I should provide them.
Is your fur baby on any medications that I will need to administer?*

YesNo
If yes, please provide the medication(s), dose, and when and how to administer
What is your fur baby’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 fur baby sleep?*
Where does your fur baby stay when you are not at home?*
If your fur baby needs to be crated or confined, how do they react?*
Please describe your fur baby’s exercise needs*
Does your fur baby have any of the following behavior concerns (check all that apply)*

Fear or reactivity to strangersFear or reactivity to animals (outside or on leash)Resource guarding or aggression around food, places, or objectsEscape behaviors (from confinement, or property)NoneOther
Please describe in more detain 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 fur baby(s)?
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 the event of an emergency requiring veterinary care? (see emergency policy below for more information)*

Contact me firstSeek immediate veterinary attentionContact 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.Format: (000) 000-0000.
What is the name of your primary Vet or Vet Clinic?*
Primary Veterinarian's Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Primary Veterinarian's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does your primary veterinarian have 24h emergency hours?*

YesNo
If No, please list the name, and number of closest 24-hour Emergency vet
Secondary Contact: In the event that you cannot be reached, Is there someone I can contact for additional support?*

First NameLast Name
Secondary Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to you*
Policies Acknowledgments
Wags & Kisses Pet Sitting and their representatives strive to create a safe, calm and comfortable environment while caring for your fur baby. Further, I the pet owner acknowledge that 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 Wags & Kisses Pet Sitting and their representatives of any and all claims of injury, expense, costs, or damages caused by the actions of my animal(s) while under Wags & Kisses Pet Sitting and their representatives care, instruction or control. Emergency Care: In the event that I cannot be reached, Wags & Kisses Pet Sitting and their representatives have my permission to react to a situation as he/she deems appropriate, and or necessary for the health and safety of my animal(s), himself,herself, or others, and that I am responsible for compensating Wags & Kisses Pet Sitting for any monetary charges made for items and or services including but not limited to, vet bills, pet food, or human medical attention. Payment Policy: For new clients, a 25% deposit is due upon booking, the remainder of the payment for services is due the day of the start of pet sitting. I except cash. Cancellation Policy: We appreciate cancellation notice as far in advance as possible. To avoid being charged the full pet sitting fee, a 72-hour notice is required. Cancelations within the 72-hour window result in the loss of your 25% deposit. 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
Should be Empty:

Pet Sitting Intake and Emergency Contact Form Template

Fur Baby Parents Information

Fur Baby Information

Care Needs

Emergency Contacts and Vet Information

Policies Acknowledgments