Jackson Pet Care — Litter Box Cleaning Request Form

Jackson Pet Care — Litter Box Cleaning Request Form

Share your setup and schedule preferences, and Jackson Pet Care will review and confirm availability and pricing.
Client Information
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Service Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Litter Box Setup
Number of traditional litter boxes that need cleaning
Number of automatic litter boxes that need cleaning
Type of litter boxes
Brand and model of automatic/self-cleaning litter box
Link to the exact product page or where it was purchased
Current photos of the litter boxes and surrounding litter area

Cancelof
Outdoor Cleaning Setup
Is there an outdoor area available for cleaning the litter boxes?
What outdoor water access is available?
Where should the litter boxes be cleaned?
Note: Litter boxes are cleaned in an agreed-upon outdoor area with access to water. Jackson Pet Care does not wash litter boxes in kitchen or bathroom sinks or in bathtubs to reduce cross-contamination risk.
Supplies
What cleaning products will you provide?
Where will the fresh litter be located?
Acknowledgment
Waste Disposal
Where should used litter and waste be disposed of?

Other
Disposal instructions
Cats During the Appointment
Anything we should know about the cat(s) while entering the home or cleaning the litter area?
Health / Sanitation
Are you aware of any contagious illness, intestinal parasites, or other sanitation concerns affecting a cat that uses these litter boxes?
If yes, please briefly explain what you are aware of
Preferred Appointment
Preferred service date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Preferred service time
Alternate date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Preferred time
If you would like this to be a recurring service, please provide your requested service schedule
Before You Submit
Automatic / Self-Cleaning Box Authorization
Authorization for Automatic / Self-Cleaning Box Care
Acknowledgment of Existing Wear or Odors
Acknowledgments
I understand that this submission is only a request and the appointment is not confirmed until accepted
Client Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Jackson Pet Care — Litter Box Cleaning Request Form

Client Information

Litter Box Setup

Outdoor Cleaning Setup

Supplies

Waste Disposal

Cats During the Appointment

Health / Sanitation

Preferred Appointment

Before You Submit

Automatic / Self-Cleaning Box Authorization