Pet Sitting Pet Form

1
Client Name* This field is required.
First Name
Last Name
2
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
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Angola
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Brazil
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Burundi
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Cameroon
Canada
Cape Verde
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Central African Republic
Chad
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China
Christmas Island
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Colombia
Comoros
Congo
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Cote d'Ivoire
Croatia
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Curaçao
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Denmark
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Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
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Guinea
Guinea-Bissau
Guyana
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Indonesia
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Iraq
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Israel
Italy
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Japan
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Jordan
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Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
3
Email* This field is required.
example@example.com
4
Phone Number* This field is required.
Area Code
Phone Number
5
Emergency Contact* This field is required.Name | Relation | Phone Number
Huge
Large
Normal
Small
Ok
Ok
6
Date to Pick Up* This field is required.
Date
Year
Month
Day
7
Date to Drop Off* This field is required.
Date
Year
Month
Day
8
Appointment* This field is required.
9
Pet/s Name:* This field is required.
10
Species* This field is required.
Canine
Feline
Other
11
Breed:* This field is required.
12
Color / Markings:* This field is required.
13
Approximate Date of birthN/A if unknown
Month
Day
Year
14
AgeCan be estimate if unknown
15
Weight* This field is required.Can be estimate if unknown
16
Sex:* This field is required.
Male
Female
17
Vaccination?* This field is required.
YESNO
18
Microchip?* This field is required.If known
19
Desexed:* This field is required.
Yes
No
No - my pet is too young at the time of completetion
Not applicable due to the species of my pet.
20
Any Medical Condition?* This field is required.ex. arthritis or dental issues
Huge
Large
Normal
Small
Ok
Ok
21
Dietary Requirement?* This field is required.ex. allergies free or kidney issues
Huge
Large
Normal
Small
Ok
Ok
22
Your Regular Veterinary Clinic* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
23
Emergency Veterinary Clinic:

Advanced Vetcare (24 Hour)

26 Robertson Street, Kensington, VIC, 3031

03 9092 0400
24
Authorised Treatment* This field is required.
YESNO
25
Services* This field is required.
Walking
In-Home Pet Sitting
Dog Park
Feeding
Grooming
26
Feeding Schedule
27
Feeding* This field is required.Amount - how much I can give Items - name of brands (Treats included if possible)
Amount
Items
AM
Row 0, Column 0
Row 0, Column 1
MID
Row 1, Column 0
Row 1, Column 1
PM
Row 2, Column 0
Row 2, Column 1
AM
MID
PM
Amount
Row 0, Column 0
Items
Row 0, Column 1
Amount
Row 1, Column 0
Items
Row 1, Column 1
Amount
Row 2, Column 0
Items
Row 2, Column 1
1 of 3
28
Treats?* This field is required.If yes, please details.
29
Exercise
30
Energy Level* This field is required.
Excited
Tiredness
Calmness
31
Lead On or Off* This field is required.
On
Off
Depends on area
32
How Often to Walk* This field is required.ex. once a day?
33
How Long to Walk* This field is required.ex. 30 minutes or a hour?
34
Visit Dog Park* This field is required.
YESNO
35
Behaviours
36
Please let us know what temperament and personality describes your pet. Check all that apply.* This field is required.
Calm
Sweet
Loving
Cuddly
Agressive
Hyper
Shy
Scared
Timid
Relaxed
Easy Going
Pushy
Suspicous
Aloof
Fearful
Lazy
Jealous
Trusting
Spiteful
Crazy
Other
37
Behaviour towards human?* This field is required.ex. friendly to strangers, growling.
Huge
Large
Normal
Small
Ok
Ok
38
Behaviour towards animals?* This field is required.ex. friendly, playing, sniffling.
Huge
Large
Normal
Small
Ok
Ok
39
Previous Training* This field is required.ex. potty training, behaviour training
Huge
Large
Normal
Small
Ok
Ok
40
Respond to command?* This field is required.if yes, please select
Sit
Turn Around
Walk
Eat
Roll Over
Come Here
Go
41
Any else commands?More if not on the lists, please details.
42
Any further work?* This field is required.ex. more trainings, new commands If not, put N/A
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Large
Normal
Small
Ok
Ok
43
Grooming
44
Grooming?* This field is required.
YESNO
45
How would you like me to groom your pet/s?If select no, please put N/A
Huge
Large
Normal
Small
Ok
Ok
46
Payments Rates

In-home sitting: $35 per day at your home | $50 per day at the sitter's home

Walk: $20 per 20 minutes | $30 per 30 minutes (including at the dog park)

Overnight: $75 per night (including feeding & grooming (if required))
47
Payment Methods* This field is required.Invoice will be provided at the end of the services.
Cash
Bank Transfer
48
Authorised to upload photos and videos of your pet/s on social media?
YESNO
49
Terms and Conditions* This field is required.
50
This form was prepared by:* This field is required.
First Name
Last Name
51
Please use your mouse or finger to sign this document electronically.
52
Signature of person preparing form:* This field is required.
Should be Empty: