Forms
Pet Information Sheet
Todays date:
Name:
Home Phone:
Work:
Cell:
Email:
Dates of Service:
1 st Visit:
Visits Per Day:
Last Visit:
EMERGENCY NUMBER where you can be reached:
Contact number for plumbing problems:
Location of fuse box:
Names, numbers and addresses of anyone else who has a key or access to the house.
Who may be in the home while service is being provided?
(Pest control, maintenance, family members, etc.)
Pet Information
Pet # 1: Species
Breed
Name
Description
Sex
Medication
M
F
Age
Spayed / Neutered
Yes
No
What commands or tricks does your pet know?
Special Instructions
Pet # 2 : Species
Breed
Name
Description
Sex
Medication
M
F
Age
Spayed / Neutered
Yes
No
What commands or tricks does your pet know?
Special Instructions
Pet # 3: Species
Breed
Name
Description
Sex
Medication
M
F
Age
Spayed / Neutered
Yes
No
What commands or tricks does your pet know?
Special Instructions
Pet # 4 : Species
Breed
Name
Description
Sex
Medication
M
F
Age
Spayed / Neutered
Yes
No
What commands or tricks does your pet know?
Special Instructions
Feeding Instructions
Where is food stored?
Amount Per Feeding:
Wet
Dry
Both
Number of Feedings:
AM
Mid Day
PM
Location of pet dishes:
Cleaning Instructions
Does pet ever have accidents?
Yes
No
What usually causes them?:
How do you clean the mess?
Location of litter box and liners
Where to enclose pets with diarrhea?
Outdoor Instructions ( DOGS )
Where is leash?
Problem with people wearing a baseball cap?
Yes
No
Is pet leash trained?
Yes
No
Where and how far to walk?
Any areas to avoid?
Problems going out in bad weather?
Yes
No
Is pet secure in yard?
Yes
No
Will pet run off if he/she gets out or off the leash?
Yes
No
How do you get them back?
Droppings in yard to be scooped?
Yes
No
Theft deterrence instructions
Bring in mail?
Yes
No
Water plants?
Yes
No
Adjust lights / drapes?
Yes
No
Newspaper?
Yes
No
Alarm instructions?
Veterinarian Information
Name:
Phone #:
Emergency # :
Medication
Where is it kept?
Pill or Liquid?
Name of Medication
Does pet take well?
In the event your pets are acting unusual
( Example: not eating, reclusive, combative )
Contact client immediately
Trust your judgment
In the event your pets are obviously sick
( Example: not eating, throwing up, labored
breathing, foreign matter in litter box )
