Valerie’s Petsitting Service Contract

Name:______

Address:______

Home Phone:______

Cell:______

E-Mail:______

Date & Time you are leaving:______

Date& Time you are returning:______

Emergency Contacts:______

Maid/Cleaning services:______

Will anyone else have access to your home while you are away? YES or NO….If yes please list names and do they have keys?______

Do you have an alarm system that I will have to use? YES or NO

If YES…. What is the code and password ______

Describe your pets:

Names: 1)______2)______3)______

Breeds: 1)______2)______3)______

Sex/Altered: 1)______2)______3)______

Feeding instructions for each pet: (Type of food, when to feed and how much) 1)______2)______3)______

Medications: (Name of meds, when to administer, amount, how to administer).

1)______2)______

3)______

Are all the dogs/cats in household vaccinated against rabies? YES/NO

Please list any history of illness:

Please describe your pets behavior with other animals/people?

Special Instructions

Bring in mail?______

Water plants?______

Garbages?______

Any other instructions please list here:

Fees, Policies and Procedures

*Fees: $50(fifty dollars) a day… Pricing subject to change.

*Payment: Valerie will accept cash and checks… Checks should be made Payable to: Valerie Nommensen. 50% of payment is due prior to you departing… This 50% is NON-REFUNDABLE. This is because I have saved this time for you and your pets and will not be able to book any other commitments. The other 50% is due the day you return.

*Returned check charges: There will be a $35 dollar fee for all returned checks... Clients are responsible for all costs of collections.

I, ______have read, understand and agree to the policies and guidelines for Valerie’s Petsitting Services. I further understand that a copy of this form will be kept on file for documenting purposes. All policies, fees and guidelines are subject to change at Valerie’s discretion.

Pet Owners Signature ______Date______

Please leave a credit card # or blank check on file for emergencies______

If you do not want to leave credit card # with me please call your local vet and leave it with them.

Veterinarian Authorization

Pet Name(s) ______

Veterinarian______

Phone Number______

Address______

Emergency Contact______

During my absence, Valerie Nommensen is caring for my pets. She has the permission to transport them to you and from your office. I authorize you to treat my pets and I will be fully responsible for All fees and charges and will pay the incurred amount on my behalf upon my return. I further authorize you to give out any information about my pets to Valerie Nommensen. I hold the above animal hospital and Valerie, harmless for any incidents occurring during transport, hospitalization and/or day-boarding.

Name of Owner______

Signature______

Date______