Service Request

Service Request
If you live in an apartment or need to skip any questions related to your home, just type no in the box provided. Thank you.
How did you hear about us?
Today's date

MonthDayYear
How did you hear about us?*
Full Name*

First NameLast Name
Email*
Phone Number*

Area CodePhone Number
Cell Phone if different from other numbers listed.

Area CodePhone Number
Vacation Phone if different from other numbers listed.

Area CodePhone Number
Address*

Street Address

Street Address Line 2

City

Zip Code
When is your birthday? We'd like to celebrate with you.

MonthDayYear
Website address
First contact with sitter
When is your birthday? We'd like to celebrate with you.
Co-caregiver info
Emergency contact info (if not local, please include a local contact as well).
Type of Service*
Hold down the CTRL key to select multiple services
Please add the dates and times for service below (if known) as well as the type of service if it's not listed. Thank you.
Do you prefer to receive updates and photos by text or email?*
What type of pets do you have, and how many??*
How often do you usually travel?*
When you have to leave your pets at home, how long do you leave them and where? [Free in the home, crated, in a bedroom, in an X pen]?*
Free in the home, crated, in a bedroom, in an X pen?
Do you or your pet have any allergies or sensitivities that I need to be aware of? If so, please describe?
Veterinarian
Veterinarian's Name
Facility Name*
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please answer the following questions when care in your home is requested or is a possibility.

Questions asked are meant to prevent issues during an emergency and keep your pets and home safe. If not applicable, type no or n/a. Thank you.
Do you have an alarm system?*

YesNo
If yes, I will get the details in person along with your WIFI login if available. Please notify the alarm company about me.
Location of nearest phone (if you have a home phone).*
Do you have working smoke and carbon monoxide detectors? *
Location of main water shut-off.*
Location of electrical/fuse box.*
Names and contact information for a plumber, electrician, handyman, neighbor, relative, or anyone that you contact for emergency home services.*
Do you have a fenced yard?*
Description of vehicles parked or allowed on your property.*
Where do you keep cleaning supplies? Please include the vacuum. Thank you!*
Would you like plants watered? Trash/recycling day? Any special instructions? Please include where trash/recycling carts, supplies for requested chores are kept. Thank you. *
Anything else?
Permission for care

I acknowledge my responsibility for the necessary medical care for my pet in the case of an emergency as well as giving my permission to administer medication as noted on my pets' profile. I have notified my pet sitter of any health and/or behavioral issues, have or will notify my Veterinarian that my pet will be in the care of a sitter, and have or will make financial arrangements for medical care prior to service. This release and statement of responsibility applies for each pet in my family, and is valid for all services provided.
Enter the message shown then click All Done!*
Should be Empty:

Service Request

Veterinarian

Please answer the following questions when care in your home is requested or is a possibility.

Permission for care