Information Form
Client Name:
Client Address:
Home Phone Number:
Cell Phone Number:
E-mail Address:
Local Emergency Contact Person & Phone Number:
Does anyone local have an extra key to your home? Yes No
If yes, what is their name & phone number?
Will anyone else be entering your home while you are gone? Yes No
If so, who
Will a gardener be coming? Yes No
If so, what day?
Do you want your pet kept in a secure place while they are there? Yes No
If so, where?
Will a housekeeper be entering your home while you are gone? Yes No
If so, what day and time and length of time
Will anyone be servicing your pool while you are gone? Yes No
If so, what day?
Do you want your pet kept in a secure place while they are there? Yes No
If so, where?
Will an extermination company be servicing you home while you are gone? Yes No
If so, what day?
Do you want your pet kept in a secure place while they are there? Yes No
If so, where?
**Please have them sign the daily visit log sheet.**
Information about your pet
Pet Name:
M F Age
Descrition:
If more than one pet, do they get along? Yes No
*If no, please give instruction on how to keep them at peace with each other*
Pet Name:
M F Age
Descrition:
If more than one pet, do they get along? Yes No
*If no, please give instruction on how to keep them at peace with each other*
Pet Name:
M F Age
Descrition:
If more than one pet, do they get along? Yes No
*If no, please give instruction on how to keep them at peace with each other*
Pet Name:
M F Age
Descrition:
If more than one pet, do they get along? Yes No
*If no, please give instruction on how to keep them at peace with each other*
Any Aggressive or behavior problems? If yes, please explain.
Any Fear of Storms? Yes No
If yes and more than one pet please list their names:
Will your pet go to the bathroom outside if it's raining?
Yes No
If no you may list any instructions or hints to get them to go outside
Are all pets up to date on their vaccines? Yes No
Are there any current diseases, illnesses, or disabilities? Yes No
If yes, please give pets name and description of problem
Where is the Food Kept?
How often & how much do you feed your pet(s)?
Does your pet have any digestive sensitivities? If so explain.
Do you allow your pet to have treats? Yes No
If yes please list type of treat and amount to be given and location of treats.
Do you give your pet table food? Yes No
If yes please list them (example: grapes, popcorn, chicken)
Does your pet require medication? Yes No
If yes which pet(s), how often, how much and where are the medications kept?
Would you like your dog walked? Yes No
Where are the leashes located?
Where do you keep plastic bags and paper towels to use on walk?
*For easy waste removal please leave out a few garbage bags, poop disposal bags, if you want a pail and scooper used.*
Where is animal waste to be disposed?
Where is the outside garbage container kept?
Where are trash bags for indoor containers?
Litter Box Care Yes No
Where is the litter box and kitty litter located?
Where is the scooper and kitty litter bags located if used?
Where is a broom and dust pan located for clean up of litter debries?
*For easy accident clean up please leave out paper towels, rags, cleaning spray or any other items that may be useful.*
Special Instruction for each pet
Home Security Information
How many vehicles should I expect to see in the driveway?
Alarm System location(s)
Alarm Company/Phone number
Alarm Entry and Exit Code
Reset code and code to be given to Alarm Company if alarm goes off
Door Entry (please circle)
Front Door Side Door Back Door Garage Door
To be locked (please circle)
Deadbolt Door Handle Both
Other Security Information
Miscellaneous Information
I will bring in Mail/Newspaper
Bring garbage to curb
What day is it picked up?
Adjust Blinds
Adjust Lighting
Water up to 10 indoor plants (each additional plant is .25 cents)
**Outdoor watering is an addtional charge**
Please list watering instructions
Additional Notes
