Pet Sitting Intake Form

Please fill out all required fields for form to properly submit. To check if form has submitted, click "Fill out intake form" button again.

"*" indicates required fields

Owners Info

First and Last Name*

Preferred Pronouns

Address*

Street Address City State ZIP Code

Phone*

Email*

Names and ages of all other people residing in the home*

Name, breed/type, sex, and age of all other pets residing in the home*

How would you like for us to access your home while you are away? Garage Code, Lock Box, Borrowed Key*

Dog's Info

Dog's Name*

Dog's Breed or Mix*

Dog's Sex*

Dog's Weight*

Dog's Color and Identifing Marks*

Is your dog neutered/spayed?*

Is your dog up to date on vaccinations?*

Would you like to upload a copy of your dog’s vaccination records now?*

Max. file size: 256 MB.

What brand of Flea/Tick, and Heartworm/Internal Parasite Preventatives do you use?*

Any known allergies?*

Yes

If Yes, Please list any known allergies your pet has.

Any other known medical conditions*

Is your dog crate-trained?*

Yes

Is your dog house-trained?

Yes

How many times is your dog taken outside to potty? Describe any details about their daily schedule that you think we should know*

Please indicate if your dog digs, jumps fencing, or is known to escape confinement*

Has your dog tried to, or slipped from a collar before?*

What brand of food does your dog currently eat?*

Amount of food your dog eats per day*

Describe your dog's feeding ritual.*

We feed during training and at meal times using enrichment feeders, such as KONG or puzzle toys. Are there any materials, specific toys, or other cautions (such as resource guarding, material shredding, or ingestion) we should know about?*

How long do you leave your dog alone each day? Are they usually crated or confined during this time?*

What items do you typically leave in the crate with your dog? Bedding, chews, water?

Additional Care and Emergency Information

Does your dog take any regular medications?*

Yes

If yes, list all Medication(s) and Dosages*

Your dog’s Primary Veterinarian (DVM)*

Does your dog have Pet Insurance? If yes, please list the company and policy #:*

In the event of an emergency, if I am unable to be reached, I give permission for life saving medical care to be performed not exceeding the dollar amount listed below.*

List the name and number of an emergency contact that will be available if you are unable to be reached in the event of an emergency*

Additional Information about your dog

How did you obtain your dog? (Breeder, Rescue, Family, Stray, etc.) How old was your dog at the time? Please describe your dog's history prior to joining your family, if known.*

Does your dog usually go on walks or in the backyard to potty?*

Is your dog allowed on furniture inside the home?*

How does your dog typically ride in the car? (In a crate, with a seatbelt and harness, in a car seat, etc.)*

How does your dog react to other people while on leash?*

How does your dog react to other dogs while on leash?*

Has your dog ever growled at a person? If so, what were the circumstances?*

Has your dog ever growled at another dog? If so, what were the circumstances?*

Has your dog ever bitten another animal? If so, please explain.*

Has your dog ever bitten a person? If so, please explain.*

List any circumstances or things your dog is afraid of:*

List any circumstances or things that your dog is aggressive towards:*

What cues (“commands”) does your dog know? How reliable is each one?*

What type of treats or toys are used to reward and motivate your dog?*

What type of equipment have you used with your dog during training and for leash walking? (Flexi/retractable leash, front/back clipping harness, head halter, choke collar, prong/pinch collar, etc.)*

Do you currently discipline your dog? Please describe how and in which situations.*: Have you ever used an electronic/shock collar?*

Are you considering using an electronic/shock collar? (This includes an invisible fence.)*

Read & Initial

Please initial at the bottom of each of the following to indicate that you've read and agree to the following terms:

I understand that all sales are final. Please initial.*

I understand I will need to give instructions for how to access my home.*

I understand that my dog must be up to date with vaccinations recommended for their age in order to participate. I understand that proof of vaccinations, administered by a Veterinarian, is required before the start of services. Please initial.*

I understand that I must provide all medications and preventatives, treats, food, and chews for my dog during their care. Please initial.*

I understand two weeks’ notice is required for a cancellation of services. I understand that my deposit is non-refundable in the event a cancellation is made without two weeks’ notice.*

I understand all fees must be paid in full within 48 hours prior to the start of services*

Field Trip Release: I authorize my dog to be transported in a vehicle and to participate in “Out and About” training to be conducted in public spaces, including but not limited to parks, trails, or shopping plazas at the trainer’s discretion. I understand Howling Moon Pet Care is not responsible for accidents that may occur during transportation.*

Media Release: I authorize Howling Moon Pet Care to photograph/video my dog during the training program. I authorize all photos or videos collected to be utilized for marketing and self-promotion purposes, including but not limited to, social media and the company website.*

Grooming Release: I understand my dog will be participating in indoor and outdoor activities that may result in the dog requiring grooming after their stay. I understand Howling Moon Pet Care cannot guarantee my dog will be free of naturally acquired dirt, debris, or tangles. I understand it is recommended that owners arrange professional grooming for coated dogs after services are completed*

I understand if my dog displays signs of illness and soils indoors, including vomiting or diarrhea, a sanitation fee may apply. I also understand if found to be necessary, an emergency bath fee may apply.*

I understand in the unlikely event my dog becomes ill, injured, or has a suspected medical emergency, I will be responsible for any and all veterinary or emergency fees up to the authorized amount. I understand Howling Moon Pet Care will make attempts to contact me for authorization of any veterinary fees should they exceed the limit provided*

I understand in the event my trainer becomes incapacitated due to a medical emergency, and is unable to fulfill Howling Moon’s standards of care, my dog will need to be transferred to the emergency contact I have provided above.*

I understand I will be provided with a copy of Howling Moon Pet Care's Release and Hold Harmless Agreement and Veterinary CAre Temporary Agent Release Agreement. I understand that services will not begin until I have signed and returned these documents to my trainer. Please initial.*

I accept all liability if any humans, dogs, or physical property are harmed or damaged by my dog during the pet care process*

919-645-8203

Info@howlingmoonpetcare.com