CLIENT GOING AWAY FORM
Please fill in this form to give our Carers all the information they need to look after your pets and home while you are away.
SCP SECURITY | CLIENT INFORMATION
Please provide your information.
Client Full Name:
*
Mr.
Mrs.
Miss
Ms
Dr
Prof
Prefix
First Name
Last Name
Business Name (If business premises):
Your Business Name here
Client Email Address:
*
example@example.com
Client Code | Account Code (SCP SECURITY):
*
This is your Account Code. It is present on your Service Agreement, Invoices and Statements from us.
Are you a Pet And Home Care Duo Subscriber with SCP Security?
Yes
No
No, but I'm interested in this offer
Address
*
Street Address
Suburb / Area
City
State / Province
Postal / Zip Code
Contact Person's Name:
*
First Name
Last Name
Contact Person's Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date and Time of Departure:
-
Day
-
Month
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Date and Time of Return:
-
Day
-
Month
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Who else has permission to be on the premises while you are away?
Rows
Name:
Relationship:
Phone Number:
Person 1
Person 2
Person 3
Person 4
SERVICES REQUIRED:
Please provide instructions as to what you would like us to do.
Lights Instruction:
Which lights should be left on or switched off?
Pet Care Instruction:
Please provide any extra instructions for each of your pets. Including food, water, medication or temperaments.
Veterinarian Name (In case of Emergency):
Veterinarian's Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Alarm Instruction:
Please provide information as to how your alarm needs to be armed and when.
Do you want scheduled Patrol Checks?
Yes
No
ACCESS DETAILS:
Please provide instructions for how we gain access.
Is there a remote?
Yes
No
Are there Gate Keys?
Yes
No
What is the Gate Code?
Any Other Instructions:
Please specify any other requests or instructions.
EMERGENCY CONTACT DETAILS:
Who do we contact in an emergency?
Emergency Contact Name:
First Name
Last Name
Emergency Contact Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Terms and Conditions:
Terms and Conditions of providing these services.
The cost of the services if any is R60 (including VAT) per day payable in advance or by debit order. (unless on Subscription - Pet & Home Holiday Duo Package)
SCP SECURITY will do our utmost to protect your permises and care for your pets. We cannot guarantee that no damage may occur, or that your pets may not get ill.
If some form of damage, storms (natural causes), or malicious, does occurr, and we feel that it requires urgent repair, the cost thereof will be for your account.
The same pplies to veterinary costs if any are necessary.
Date Submitted for Creation:
*
-
Day
-
Month
Year
This date will appear on the Certificate as the creation date.
Acceptance Signature of Client:
Submit
Should be Empty: