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45839
CLIENT INTRODUCTION FORM
Client Contact Information
Client Name
First
Last
Address
Street Address
ZIP / Postal Code
Mobile Number
Work Number
Email Address
Emergency Contact Information
Emergency Contact Name
First
Last
Do the have a key?
Yes
No
Relationship to Owner
Mobile Number
Work Number
Email Address
Vet Information
Vet's Name
Vet's Address
Street Address
City
ZIP Code
Phone Number
Hours of Operation
Email Address
Pet Information
Pet's Name
Pet's Age
Animal Type
Sex
M
F
Neutered/Spayed
N/A
Y
N
Fully Vaccinated
Y
N
Up to date with flea and tick treatments?
N/A
Y
N
Is your pet insured?
Y
N
Insurer
Tag on collar?
N/A
Y
N
Crate used?
Y
N
Microchipped?
Y
N
Treats allowed?
N/A
Y
N
Allergies/Intolerances?
Y
N
More Information
Is medication required?
Y
N
If yes, please fill out medication form.
More Information
Medical Conditions?
Y
N
Please tell us about your pet's temperament.
Distinguishing Features
How does your pet react to being in a car?
Any limited or impaired sensory functions?
Feeding Times
Quantity
Is your dog allowed off lead?
Yes
No
If yes, please sign off lead waiver.
Pet Information Continued
Has your pet ever shown signs of aggression towards a person or another animal?
Yes
No
If yes, please explain below.
Any beahvioral concerns (guarding things, noise phobias, etc.)?
Dog Sitting Only
Skip if not relevant.
Does your dog require a muzzle?
Yes
No
N/A
Does your dog have good recall?
Yes
No
If yes, please give details.
How does your dog respond to the following:
Cats
Dogs
Birds
Squirrels
Please indicate where the following are kept:
Towel
Lead/Collar
Toys
Please indicate where the following are kept:
Treats
Brushes
Cleaning Supplies
My pet loves:
My pet hates:
Pet Sitting Details
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
How many visits per day?
1
2
3
4
Full Payment Due
House Information
Will you be providing a key?
Yes
No
If no, please give details on how we will enter home:
Will there be anyone in your home?
Yes
No
Will house alarm be on?
Yes
No
Alarm Code
Restricted areas of the house?
Yes
No
Please specify:
Which door will I be entering from?
Client Consent
Client Name
First
Last
Date
MM slash DD slash YYYY
Client Signature
Extra Information
4163
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