Pet-Sitting Services Client Agreement and Information

Name:_______________________________________________________________

Address:_____________________________________________________________

City:________________________        State: ___________________     

 Home Phone: (___) _________________Work Phone: (___) ________________    

Cell Phone:  (____) ___________________

Email: _____________________________________________________________

Emergency Contact::__________________________________________________

Location of Extra Key: _________________________________________________

Alarm Deactivation Code: ______________________________________________

Alarm Activation Code: ________________________________________________

Alarm Company Name: _________________________________________________

Alarm Company Phone: _________________________________________________

I agree that I have requested “Loza’s Pet-Pals of RGV” to take care of my pet. I agree to pay the charges accrued for the services provided as outlined in this agreement.

Charge Per 30-minute Visit: $15.00

I understand that payment is due on or prior to the time of the initial visit

Owner's Signature: ___________________________________________________

Date:_____________________________________________________________

Owner's Name (please print):____________________________________________

                                             Pet Sitting Assignment Information

Date of Initial Visit: ___________________Date of Final Visit: __________________

Number of Visits per Day: (additional fees accessed) ____________________

Total number of visits: __________Overnight: ___________Daily: ___________

Additional duties (please circle those you would like to request):

Bring in mail/newspapers

Water plants

Put out trash cans/recycling

Other

Where can you be reached?

Address: ___________________________________________________________

Phone: (_______) _________________________________

Email: ______________________________________________________________

Do you want Loza’s Pet Pals of RGV to confirm you have returned on time and continue to visit if I do not hear from you?      YES / NO

Should Loza’s Pet Pals of RGV contact you during the visit?   YES / NO

If yes, please indicate when, how, and how often: _____________________________

__________________________________________________________

Additional Notes: _____________________________________________________

___________________________________________________________

VETERINARY INSTRUCTIONS AND RELEASE FORM

Pet’s Name:_________________________________________________

Description:____________________________________________________

Age:________________________________________________________

Medical conditions/medication:___________________________________

Pet’s Name:_________________________________________________

Description:__________________________________________________

Age:_______________________________________________________

Medical conditions/medication:___________________________________

Pet’s Name:_________________________________________________

Description:__________________________________________________

Age:________________________________________________________

Medical conditions/medication:___________________________________

If any of the pets named above becomes ill or is injured, I request that Loza’s Pet Pals of RGV take the pets to:

Veterinary Office Name: _______________________________________

Address: ___________________________________________________

Phone Number: ______________________________________________

Alternate Veterinary Office Name: ________________________________

Address: ___________________________________________________

Phone Number:_______________________________________________

Loza’s Pet-Pals of RGV has my permission to authorize treatment up to $_____________.

I will assume full responsibility upon my return for payment and/or reimbursement for veterinary services rendered up to the above stated amount.

If neither of the veterinary offices named above is available, I authorize Loza’s Pet Pals of RGV to take my pet(s) to another veterinary office for treatment. I understand that Loza’s Pet Pals of RGV will not be held responsible for the results of the veterinary treatment or the loss of my pet.

This agreement is valid upon signature.

Owner's Signature: ___________________________Date: ____________

Owner's Name (please print):____________________________________

PET INFORMATION SHEET

Owner’s Name: ______________________________________________________

Pet’s Name: ________________________________________________________

Age:_____________ Breed: _____________ Color/Markings: __________________

Sex: M or F _____ Neutered / Spayed___________________________

Rabies Tag Number: ___________ Date Rabies Shot Expires:___________________

Feeding:

What Food Does Your Pet Eat? __________________________________________

When Does Your Pet Eat?  _____________________________________________

Special Feeding Instructions: ___________________________________________

__________________________________________________________________

Medication: Is your pet on any medications that must be administered? If yes, please describe the medication procedures including name, dosage, and where medicine is located.  _____________________________________________________

Miscellaneous:

Pet’s Favorite Toy or Game? ____________________________________________

Pet’s Favorite Hiding Place? ____________________________________________

Does Anything Bring Your Pet Out of Hiding? ______________________________

Location of Pet’s Collar / Leash? ________________________________________

Does Your Pet Require a Special Harness or Choke Collar for Walks? ______________

If Pet is a Cat:  Is the cat allowed outdoors? _________________________________

Please answer the following questions about your pet’s traits:  

Is Friendly with Other Pets? YES / NO

Likes New People? YES / NO     Likes Adults? Yes / No     Likes Children? YES / NO

Must Stay on Leash During Walks? YES / NO / N/A

Is Allowed in the House? YES / NO

Is Allowed to Have Treats? YES / NO

Is Prone to Digging? YES / NO

Is Prone to Chewing? YES / NO

Is Fearful of Noises or Other Things? YES / NO

Obeys Basic Commands? YES / NO

Has Bitten People or Other Animals? YES / NO

Has Shown other Aggression? YES / NO

Traits Specifically for Cats:

Declawed? YES / NO

Tries to Escape? YES / NO

Will Not Eat When Stressed? YES / NO

Prone to Hairballs?  YES / NO

Uses the Litter box Reliably? YES / NO

Fearful of Loud Noises? YES / NO

Likes to be Petted?  YES / NO

Likes to be Held?  YES / NO

Please indicate anything else about your pet’s habits or behavior that would be useful in providing care: _______________________________________________________