PET SITTING Client Intake Form
1. CLIENT INFORMATION
Full Name:
First Name
Last Name
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email:
example@example.com
Phone Number:
Format: (000) 000-0000.
2. EMERGENCY CONTACT
Name:
Phone Number:
Format: (000) 000-0000.
3. PET INFORMATION
Pet's Name:
Male
Female
Type of Animal:
Breed:
Age:
Weight:
Color:
4. MEDICAL INFORMATION
Vet's Name:
Phone Number:
Format: (000) 000-0000.
Current Medications:
Allergies:
Moonstruck Pet Sitting
moonstruck.dogsitting@gmail.com
203-689-3336
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5. FEEDING INSTRUCTIONS
Type of Food:
Amount per Feeding:
Feeding Times:
6. BEHAVIORAL INFORMATION
Is your pet friendly with other animals?
Yes
No
Is your pet friendly with children?
Yes
No
Any aggressive behaviors?
Yes
No
If yes, please specify:
7. BEHAVIORAL INFORMATION
Preferred Walk Times:
Exercise Limitations:
8. HOME INFORMATION:
Location of Pet Supplies
ocation of Cleaning Supplies:
Any areas pet is not allowed?
9. ADDITIONAL SERVICES
Additional Services
Grooming
Training
Other
10. ACCESS TO HOME
Key Code:
Alarm Code:
Client Signature:
Date:
-
Month
-
Day
Year
Date
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PET SITTING Photo and Video Release Form
I, the undersigned, hereby grant Moonstruck Pet Sitting ("Company") permission to use photographs and videos taken of me and/or my pet(s) during pet sitting services for any legal use, including but not limited to: publicity, copyright purposes, illustration, advertising, and web content.
RELEASE DETAILS
I understand that I will not receive any monetary compensation for the use of the photographs and videos, and I hereby waive any right to inspect or approve the finished photographs, videos, or printed or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown.
I also understand that this material may be used in diverse educational settings within an unrestricted geographic area.
Photographic, audio, or video recordings may be used for the following purposes (please check all that apply):
Photographic, audio, or video recordings may be used for the following purposes (please check all that apply):
Website content
Informational presentations
Social media
ACKNOWLEDGMENT:
I hereby hold harmless, release, and forever discharge the Company from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.
Client Signature:
Date:
-
Month
-
Day
Year
Date
Moonstruck Pet Sitting
moonstruck.dogsitting@gmail.com
203-689-3336
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