Client Contact And Information Form

It is important that our database contains as much information as possible about our clients, their pets, and their caregivers, especially if an emergency were to arise. Please fill out the form and click submit at the end of this page.

NOTE: Please type in the letters ‘NA’ (not applicable) in all the fields that do not apply to you. All fields are required to be filled in. Otherwise the form can not be submitted.

Client Contact and Information Form

Please enter your email address and check the CC box below to ensure you get a copy to print out and leave in your home(required)
CC me this Form
Name of pet(s):(required)
Breed(s):(required)
Age and Birthday(s):(required)
The 2 hour window you'd like, or have already chosen for us able to arrive within is: (walking clients only)(required)
Owner(s):
(A) Name:(required)
(A) Complete Address including zip code(required)
(A) Email address:(valid email required)
(A) Telephone Numbers:
(A) Home:(required)
(A) Work:(required)
(A) Cell:(required)
(A) Best Number To Call:(required)
(A) Best way to contact you, email and/or phone:(required)
(A) Best time to contact you:(required)
(B) Name:
(B) Complete Address including zip code
(B) Email address:
Telephone Numbers (B):
(B) Home:
(B) Work:
(B) Cell:
(B) Best Number To Call:
(B) Best way to contact you, email and/or phone:
(B) Best time to contact you:

Veterinarian Information

Veterinarian Establishment:(required)
Complete address including zip code:(required)
Doctor(s):(required)
Telephone:(required)
Fax number:
Best way (email, work, home, cell) and time to contact:(required)

Other Pertinent Information Regarding Your Dog's Care

Where are the leashe(s) kept?(required)
Important Note:
Please make sure you have a non retractable/non elastic leash(s) for us to use
Where do you keep towels for rainy and/or snowy days?(required)
If your dog(s) has a coat and you use Paws Wax, etc… to protect their paws from salt burn please let us know where they are kept.(required)
When the days are shorter during fall or winter, if you’d like us to leave a light on , please specify which one:(required)
Does your dog(s) have any behavioral issues that you feel we should be aware of? (Tries to eat things on the street, fear of roller bladers, loud sounds, aggression of some kind, etc)(required)
Besides contacting you immediately if your dog seems ill, lethargic, and/or has any symptoms such as vomiting or diarrhea, etc., is there anything else you’d like us to do?(required)
If we're going to be walking your dog(s) on a regular basis, it's best for us if you pay by the week and on the same day. Please let us know which day would be best for you so we'll know to look for your payment.(required)
Where in your home will you be leaving the payment envelope? Please be specific.(required)
Where in your home will you be leaving this filled out form? Please be very specific.(required)
Please note anything else you'd like us to know so we can service you and your pet(s) to the best of our ability.(required)

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Dorothy's Petcare

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Client Contact And Information Form