Date you want your sitter to arrive?
*
-
Month
-
Day
Year
Date
Time you want your sitter to arrive?
*
Hour Minutes
AM
PM
AM/PM Option
Time you want your sitter to leave?
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Hour Minutes
AM
PM
AM/PM Option
Date you want your sitter to leave?
-
Month
-
Day
Year
Date
Pet Information
Provide accurate and up-to-date information regarding your pet(s)'s routine, behaviour and preferences, so that we can ensure all their care needs are met and that they are happy whilst in our care
Name:
*
Date of Birth:
*
Gender:
*
Male
Female
Spayed/Castrated/Neutered/Entire:
*
Spayed
Castrated/Neutered
Entire
Type of animal & Breed
Microchip Number:
Date of last Vaccinations:
*
-
Month
-
Day
Year
Date
Date of last worming treatment:
*
-
Month
-
Day
Year
Date
Date of last flea treatment:
*
-
Month
-
Day
Year
Date
Date of last Kennel Cough (for dogs):
-
Month
-
Day
Year
Date
Country of birth?
*
Homed as a puppy/kitten?
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Yes
No
Rescue?
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Yes
No
Human Information:
Provide owner's information for our records and correspondence, this will be kept confidential at all times
Name:
*
Full address:
*
Mobile/Home Number:
*
Email Address:
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Emergency Contact Information
YOU MUST PROVIDE THIS IN CASE WE NEED SOMEONE ELSE TO CARE FOR YOUR DOG WHILE YOU'RE AWAY
Name:
*
Full address:
*
Mobile/Home Number:
*
Email Address:
*
Vet Contact Information
You must inform your vet when you're away and when your pet is in our care and must grant us permission to speak to the vet about your pet on your behalf
Name of Vet/ Surgery:
*
Full Address:
*
Contact Number.:
*
Veterinary Release Form
The welfare of your pet is paramount. We will always contact the vet for any concerns, so that they can give necessary advice. We also record this information. In the case that your pet may need veterinary support /treatment or hospitalisation whilst boarding with HILLCOTE PETS, we ask that you agree and sign the following form. To the Businesses Registered Vet/Pet’s own Vets/Animal Hospital: HILLCOTE PETS is an insured Pet Care Business and is contracted to look after my pet(s) whilst I am away. They have my permission to place them in your care in case of an emergency. Kayleigh, or a member of her team, will attempt to contact me as soon as medical care is deemed necessary. However, in the event I cannot be reached immediately, I authorise you to treat my pet(s) and will be responsible for payment of any fees as stated below.
Pet Owner:
*
I agree
Veterinary Clinic Address:
*
Phone:
*
If above named veterinarian surgery is not available, I give my permission for Kayleigh Rivett at HILLCOTE PETS to take my pet(s) to her business registered vet or to the nearest animal hospital or emergency clinic. I give permission for Kayleigh Rivett at HILLCOTE PETS to approve treatment up to this amount in GBP:
*
INSURANCE DETAILS & POLICY No:
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I understand that HILLCOTE PETS assumes no responsibility for the loss of any pet and is released from all liability related to treatment. I also agree to be responsible for all special services assessed by HILLCOTE PETS for emergency transportation, care or supervision and will pay fees when I return to England. Injury and Indemnification. If pet owner’s pet(s) accidentally dies, becomes ill or injured, the dog owner waives and releases HILLCOTE PETS from any claim arising from such an incident. In the event of the pet’s death the owner will be contacted imminently, and the pet removed to the local vets for storage until the owners return. Other conditions, If any:
*
My pet(s) has/have the following health issues:
*
My Pet takes the following medication:
*
This consent for treatment has no expiration date and grants permission for future veterinary care without the need for additional authorization each time my business cares for one or more of my dogs unless otherwise noted. WE WILL PROVIDE 2 COPIES OF THIS VETERINARY RELASE FORM (PAGE 2) (One for your vet to have on file and one for my business records). Please indicate you agree by ticking the box below:
*
Yes
No
KENNEL COUGH: As per our terms and conditions all dogs must have the Kennel Cough vaccination 2 weeks+ prior to a pets it. In some cases where this is not possible the owner must sign the disclaimer below.I take full responsibility if my dog contracts the Kennel Cough virus during while I am away/going out for walks & therefore, I will not make any claim on HILLCOTE PETS business insurance nor will I hold HILLCOTE PETS responsible for any illness or death of my dog. I will however take full responsibility for my dog infecting others, who are vaccinated, & pay for any costs incurred by any dog that contracts the virus due to my dog not being vaccinated. Any costs incurred (treatment, medication etc) including mileage (charged at £0.50p/mile) must be paid to HILLCOTE PETS within 5 days of any medical intervention by a Veterinarian. I confirm that I understand the above:I confirm that I understand the above:
*
Yes
No
CONTINGENCY PLANNING:
In the event of illness or injury
Worst Case scenario: If your pet is injured or dies in our care, under our license regulations we must take your dog to be stored at their vets, until you return. Do you wish to know straight away or when you get back?
*
Away
Back
PET PROFILE:
Please tell us more about your pet's personality, behaviour, preferences and care needs. Please not that some questions are targeted towards one particular species e.g. dogs
Does your pet get along well with others of the same species?
*
Yes
No
Not Applicable
Does your pet get on with puppies/younger pets of the same species?
Yes
No
Does your pet show any destructive behaviours, when you are not at home? Does your pet suffer from separation anxiety?
*
Yes
No
N/A
Does your dog have obedience training?
*
Yes
No
N/A
Is your dog house trained/toilet trained?
*
Yes
No
N/A
Does your pet destroy toys?
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Yes
No
Has your pet bitten a human before?
*
Yes
No
Has your pet been attacked by another pet before?
*
Yes
No
What commands does your dog/pet know/ use?
*
Does your pet travel well in a car? If so where do they sit? All dogs have a seat belt attached to their harnesses in our vehicle. Please provide a harness.
*
Does your dog recall with distractions (e.g. other dogs?) Do you use recall tools? Can your dog be walked off lead in safe areas away from roads? Is your dog reactive or aggressive on a lead or do they pull on the lead when walked?
*
Does your pet use a crate or pen and if so how long does it stay in there for? And where does your pet sleep? When you go out and leave your pet at home, where do you leave them (room, crate, bed?)? Do you give them anything to keep them occupied and if so what?
*
ABOUT YOUR PET & YOU
Is your pet food and/or toy oriented? What’s their favourite toy? What treats or food do they enjoy?
*
Are you aware of any resource guarding issues?
*
When you are at home, what games do you play with your pet? What enrichment activities to you do, and, or what tools do you use? What other activities do you do with your pet at home?
*
Has your veterinarian given you any advice regarding health & well-being for your pet? If so what?
*
How often do you groom your pet? Any difficulties with washing, brushing, drying? What is your grooming routine? Does your pet mind having their coats checked for foreign objects etc, and washed if necessary (rolled in fox poo)?
*
OTHER HUMANS
How sociable is your pet/s with humans (including children)? Do they interact with each other appropriately? Are there any concerns?
*
Is your pet regularly groomed by another human (not family related)? How do they react? Any issues/concerns/behaviours?
*
PETS TOGETHER
Has your pets ever displayed reactive, fearful or nervous tendencies? (no matter how small) Are they scared of noises?
*
How does your pet get on with other pets? At home, out on a walk? Do they play ok together? Have you encountered any problems? Received feedback from other services/professionals?
*
FOOD & NUTRITION
What does your dog eat, time, brand, quantity?
TIME (AM):
*
Hour Minutes
AM
PM
AM/PM Option
TIME (LUNCH):
*
Hour Minutes
AM
PM
AM/PM Option
TIME (PM):
*
Hour Minutes
AM
PM
AM/PM Option
BEDTIME TREAT?
*
FOOD BRAND:
*
QUANTITY:
*
TYPE:
*
Raw
Wet
Kibble/Dry:
Cooked:
Do they use a slower feeder for eating their food?
*
Does your pet resource guard over food / treats?
*
Yes
No
If your pet has dried kibble, do you scatter feed? (includes treat ball (enrichment tool))
*
Are they allergic to any type of food, ingredient?
*
EATING THEIR MEALS / FEEDING IN SAME ROOM (6.0)Generally, we feed all pets separately. We are always in the room or close by when the pets are eating (unless you explicitly ask us not to be) to manage any situations that may arise.
*
OWNERS PERMISSIONS - EXERCISING OFF LEAD (dogs only)
OFF LEAD/LONG LINE LEAD PERMISSION REQUIRED We always keep dogs on-lead unless you agree to give us permission to let them off lead. We only let the dogs off after a period of getting to know them, and areas away from the main road. We can use long lines as an extra precaution. Please read and sign the form below:
I give permission for HILLCOTE PETS to walk my dog off lead in enclosed areas and areas away from roads, or on a long line as an alternative. (delete where necessary) By permitting this, I will not hold HILLCOTE PETS responsible for any: • Loss of my dog, • Injury to my dog, • Injury to another animal by my dog, • Injury to a member of the public, or • Death of my dog nor will I make a claim on HILLCOTE PETS insurance company, unless the company is found to be negligent.
*
I agree
EXTRA OWNER PERMISSIONS
ARE YOU OK WITH YOUR OWN PETS BEING IN THE SAME ROOM TOGETHER?
*
Yes
No
N/A
BEING TRANSPORTED WITH OTHER PETS IN OUR VEHICLE (5.6) Your pet will travel either in the boot or back seat of the car (safely in a crate/carrier if a smaller animal). And clipped in as per Rule 57 of the Highway Code. Where possible they must have a harness.
*
Yes
No
WALKING & EXERCISING OUTSIDE OF THE HOUSE WITH OTHER DOGS (7.2) (only dogs) Your dog will only be one of up to 6 dogs to be walked at any one time. (as per Animal Welfare Regulations 2018 & as per my insurance though I generally walk no more than 4). Each dog will be assessed to check compatibility to walk/exercise together.
*
Yes
No
N/A
BEEN CHECKED OVER & DAILY GROOMED (5.3)(During our stay your pet it will be beneficial for them to have their body, paws, eyes, ears, teeth. gums etc checked daily, particularly after walks (dogs only) for foreign objects (grass seeds, other vegetation, parasites etc). We will also check for matting and if necessary remove it, as this can cause your pet unnecessary pain. Are you okay/or not okay with me carrying out this task. Please, provide their own grooming equipment. HILLCOTE PETS will monitor your dog’s behaviour during a body check and will cease if we feel that the dog is unhappy or uncomfortable in any way).
*
Yes
No
PETS BEING LEFT WITH OUR EMERGENCY CONTACT PERSON (5.9)In the case that we need to take another pet to the vet for an emergency, or need to leave the house for a short period of time. Are you okay with me leaving your pet in the care of another insured person from Hillcote Pets?
*
Yes
No
I, the owner named on this form, am giving consent to HILLCOTE PETS to act as my pet’s guardian whilst my pet is in their care, and allowing my pet to participate with activities with other pets at their home and out on a walk. I therefore will not, nor cannot hold HILLCOTE PETS responsible for any: • injury to my pet, • injury to another animal by mypet,• injury to a member of HILLCOTE PETS or • death of my petnor will I make a claim on HILLCOTE PETS business insurance if any issues occur, unless HILLCOTE PETS is found to be negligent.
*
I agree
OWNER’s RELEASE
Please note some photos /videos may be used on our Facebook page/Instagram/social media/website: HILLCOTE PETS will post these after their visit. Are you as an owner okay with this?
Please tick yes or no below if you are okay with this:
*
Yes
No
Please let us know the preferred ways to keep you up to date with your dog’s stay with us, including videos and photos: WhatsApp/Facebook/Messenger/Email:
*
By signing this pet sitting form, you are agreeing to, and are contractually bound by our terms and conditions. You agree that the information recorded on this document is accurate. I hereby confirm that I am the owner of the named pet written at the beginning of this dog boarding form, and I authorise Kayleigh Rivett at HILLCOTE PETS to act as guardian during my absence and agree for her to make any decisions regarding my pet’s health providing it is acting in the best interest of my pet and is on the advice of the registered veterinarian with whom my business is registered with:
*
I agree
Please note that HILLCOTE PETS is required by law to keep records/a register of your pet & relevant details for a minimum of three years for Inspection by the local council (East Hampshire District Council). PLEASE NOTE: ALL FORMS MUST BE FILLED IN BEFORE YOU ARRIVE AT CONSULTATION. WE WILL GO THROUGH THEM WHEN YOU ARRIVE. ALL DOCUMENTS, WILL NEED TO BE SIGNED PRIOR TO OUR MEET AND GREET TRIAL ASSESSMENT.OUR MEET & GREET TRIAL ASSESSMENT: We do a meet and greet so we can : Observe your pet in your home and out on a walk, assess their needs and assess how they cope in a new environment with new animals & humans, so you and your pet can get to know us before the Pet Sit. Fill in any other necessary forms etc. and so you can meet the HILLCOTE FAMILY and ask any questions. We hope you will go away feeling more relaxed about pet sitting if you have never used this kind of service before. In the case you do not feel that this is the right place for your pet, or our assessment demonstrates that your pet is not suited, we will be happy to recommend others that may be more suitable.Please confirm you understand the above.
*
I understand
Privacy Notice.You (owner), give your consent that your details, and any data relevant to my work, will be held on record by myself, Kayleigh Rivett of HILLCOTE PETS, and processed under the terms of the General Data Protection Act 2018. In general terms this means:I have lawful basis, which in this case is to fulfil my contract with you. My purpose is to look after your pet(s) as agreed in writing. This data may be shared with colleagues, or relevant agencies, i.e. Veterinary staff, Police, RSPCA or rescue centres, Council & Government Departments if requested. If needed this may include processing your data to my colleagues, who if outside the EU, I will have ensured have proper procedures in place. Records will be securely kept and will not be kept for any longer than deemed necessary. You have the right to ask for your records to be viewed, amended, or deleted and you have the right to withdraw consent. You also have the right to complain to the overseeing regulator, the ICO, (www.ico.org.uk) if you feel your data has not been handled correctly.
*
I agree
Signature
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