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Client Registration and Initial Service Agreement Print E-mail

If you use Yahoo.com for your email: We are currently having issues with customers using Yahoo.com email addresses. Until we resolve this problem we ask you please use a different email address (gmail, hotmail, etc..) if you have one. If you do not have a different address please call us instead (979) 690-7874.

Thank you.

First Name:
Last Name:
Address:
City:
Zip Code:
Home Phone:
Office Phone:
Cell Phone:
Cell Phone:
Email:
Email:

In an emergency, if we are unable to reach you, whom may we contact locally?

Name:
Address:
Home Phone:
Office Phone:
Cell Phone:
Relationship:

Does this person have a key to your home? Yes No

Do you authorize this person to make medical and financial decisions for your pets on your behalf? Yes No

Does anyone else have access to your home? Yes No

If yes, please describe:


Do you have a house alarm? Yes No

If yes, please provide the following:

Name of Alarm Company:
Phone:
Alarm Deactivation Code:
Alarm Activation Code:
Location of Alarm Panel:

If applicable, what is your Gate Code?

Number of Keys Issued:

Please return my keys after the initial series of visits.

Please keep my keys for future visits


Please fill out the following if you will be out-of-town when we first visit your pet/s.

Date Leaving: <-click here to select date
Time:
Date Returning: <-click here to select date
Time:

Number of Visits/Day:
Time of Visit/s:
Total Number of Visits:

Do you want us to:

Bring in the mail/newspapers? Yes No
Water indoor/outdoor plants? Yes No
Take out the trash? Yes No
Perform home security tasks? Yes No

Special Instructions:


While away, what is the best way to contact you?


I authorize Phil's Pet Sitting Service to care for my pet/s. I agree to pay the charges accrued for the services rendered, as outlined in this Agreement.

I understand that payment is due at, or prior to, the time of the first visit, unless other arrangements are made. I understand that Phil's Pet Sitting Service requires an additional $25 for returned checks. Personal checks should be made out to Phil's Pet Sitting Service.


How did you hear about Phil's Pet Sitting Service?




 
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