Not Fur Gotten Questionnaire Form

NAME:
EMAIL:
PHONE:


ADDRESS: Where sitting takes place
City:
State:
Zip:
Cell Phone:
Work Phone :

 

Start Date :

End Date :

Return Date :

Number of visits per day?:

Pet (s) Name :

Breed / Species :

Age / Sex / Color :

When Fed? :

What do you feed them? :

How many litter boxes? :

Method of changing litter boxes? :

Medical conditions ? :

Meds / Dosage :

Does your pet require medication, including insulin shots regularly? Yes No

Please describe special care or concerns in 100 characters :

Security System ? Yes No

 

Walk ? Yes No

 

Aquarium ? Yes No

If yes, describe them :

When do I feed the tank ? :

What do I feed them ? :

Any birds? Yes No

Please describe them :

What do I feed them ? :

When do I clean the cage ? :

How often ? :

Veterinarian Clinic and Vet's Name
City:
State:
Zip:
Cell Phone:
Office Phone :

 

Courtesy services performed at no additional charge. Please indicate what
ones you will require?
Bring in mail Mail/ newspaper Yes No
Water plants Yes No
Alternate lighting Yes No
Open/shut blinds Yes No
Trash Yes No
Monitor pool or sprinkler system Yes No

Best time to call for quote and schedule pre pet sitting visit

Do you have an upcoming tentitive scheduled date?
mm/dd/yyyy

How did you hear about Not Fur Gotten Pet Sitting?
Yellow Pages Newspaper
E-Mail marketing Internet Search

How would you like to receive your quote?
E-mail
Phone

Due to the highly sensitive nature of aquariums and birds. Not 'Fur' Gotten assumes no liability for loss of any fish, invertebrates or birds during period of contract. Do you understand and agree to consent to this release? Yes No