Service Consultation Information Form

Enter your Contact Information

 

Name:
Address:
Subdivision:
City:
Home Phone:
Cell Phone:
2nd Cell Phone:
Work Phone:
Email Address:

 

Do you have an alarm? If you do, we will need the code and company info at the consultation.

Select Yes No

 

If you don't live in or near a common location, please provide directions.

 

Please continue to Step 2 - Emergency Contacts

 

Enter your Emergency Contact Information

 

If you have a local emergency contact - this is usually a family member or friend - enter their information here:

Name:
Home Phone:

Do they have a key?

Select Yes No

 

Do you have a trusted neighbor who also has a key or can be contacted in case of emergency, enter their information here:

Name:
Address:
Home Phone:

Do they have a key?

Select Yes No

 

Which Veterinarian do you use?

Name:

 

Please continue to Step 3 - Your Pet's Information

 

 

Please continue to Step 4 - Pet Sitting Services

Enter the Pet Sitting Services you would like

Please complete only the sections for the services that you are requesting.

 

Vacation and Out of Town Services

If you are going out of town or on vacation, please complete this section.

 

How many House Call visits per day would you like?

 

How many Extended House Call visits per day would you like?

 

Would you like any of these Home Care Services (included w/ service)?:

Mail
Newspaper
Alternate Lights
Water Plants
TV/Radio
Garbage

 

Dog Walking Services

If you are looking for us to come on a weekly basis, whether it's once a week or every day, please complete this section.

 

How many days per week would you like Dog Walks?

 

How many walks per day would you like?

 

If you know which days of the week you'll need, please select them here:

Monday
Tuesday
Wednesday
Thursday
Friday

 

We break up dog walks into to time periods: 11am-2pm and from 2pm-5pm. Which time period would you like us to visit your pets (note: if you are requesting more than one visit per day, you can select two times):

11am-2pm 2pm-5pm Other

 

Pet Waste Removal

If you would like Pet Waste Removal services, please complete this section.

 

How many days per week would you like Pet Waste Removal?

Select Days Per Week 1x per week 2x per week Just One Time

 

How many dogs do you have?

Select # of Dogs 1 Dog 2 Dogs 3 Dogs 4 Dogs More than 4 dogs

 

Pet Waste Removal Comments:

 

Other Pet Sitting Services

If you need a different type of service, please complete this section.

 

I need a different service:

Select a Service Overnight Stay Puppy Playtime @ the Park Shopping/Delivery Pet Taxi Doggie Bath

 

Miscellaneous Instructions:

 

Other Information

Would you like us to keep your key for future visits? Most clients prefer us to keep their key on file (locked in a lock box) for future visits.

Select Yes No

 

Supply Locations: Food, Cleaning, Leashes, Litterbox, Garbage

Food: Cleaning Products: Leashes: Litterboxes: Garbage:

 

Please continue to Step 5 - Schedule Consultation & Services

 

Schedule your Service Consultation AND Service Dates

 

I want to Schedule a Service Consultation for:

Date:
at: Select a Time 8:00 am 9:00 am 10:00 am 11:00 am 12:00 pm 1:00 pm 2:00 pm 3:00 pm 4:00 pm 5:00 pm 6:00 pm 7:00 pm

 

I am looking for Pet Care:

from:
To:

 

If you are going out of town, please let us know:

What time will you be leaving:

Leaving: Select Time between 12am-6am 7:00am 8:00am 9:00am 10:00am 11:00am 12:00pm 1:00pm 2:00pm 3:00pm 4:00pm 5:00pm 6:00pm 7:00pm 8:00pm 9:00pm 10:00pm 11:00pm

 

What time will you be returning:

Returning: Select Time between 12am-6am 7:00am 8:00am 9:00am 10:00am 11:00am 12:00pm 1:00pm 2:00pm 3:00pm 4:00pm 5:00pm 6:00pm 7:00pm 8:00pm 9:00pm 10:00pm 11:00pm

How would you prefer that we contact you?

Email Me
Call Me

 

Please continue to Step 6 - The Last Step - Final Questions

 

Final Questions

 

Any other comments or notes we should know:

 

Please tell us how you found our website (i.e. Googled "West Chester Pet Sitters")

 

Please rate this process where 1 = Too confusing/hard/long and 5 = Very easy and helpful.

Select 1 2 3 4 5

 

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