About You

Your Name:

Email Address:

Home Address:

Daytime Telephone Number:

Evening Telephone Number:

Mobile Telephone Number:

About Your Dog

Dogs Name:

Service Required (in your own home): Animal Feeding Service Day Care In Your Home - One Day Only Day Care In Your Home - More Than One Day Long Term Care In Your Home - Holidays etc Overnight Care In Your Home Pet Taxi

Dates Required:

From: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 2002 2004 2003

Time of Arrival (24Hr):

To: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December 2002 2003 2004

Time of Departure (24Hr):

Please check all days that apply if you wish to look after your dog on set days each week

Monday: Tuesday: Wednesday: Thursday: Friday: Saturday: Sunday:

Dogs Breed:

Dogs Weight:

Dogs Age:

Male: Female:

Neutered: Spayed:

Feeding Times:

Feeding Quantity:

Table Snacks Allowed: Yes: No:

Feeding Comments:

Dog Pleasures

Enjoys Walks: Yes: No:

Walk Times:

Walk Comments:

Walk Distance:

Dog Passions

Likes The Car?: Yes: No:

Likes Children?: Yes: No:

Dog Phobias eg Thuderstorms:

Does your dog have the run of your house?: Yes: No:

Grooming comments:

Day sleep place:

Night sleep place:

Known commands:

Can strangers approach your dog: Yes: No:

Dog Provisions

Is your dog house trained: Yes: No:

Any medication?:

Any special needs?:

Vet name:

Vet address:

Please add any information you feel we need to know to ensure the best possible care for your dog in the box below.

Insurance

It is the dog owners responsibility to ensure that adequate pet insurance is in place. K9 Good Care will not be held responsible for any accident, loss or injury howsoever caused.

Declaration

I have read, understood and agree to the terms and conditions: