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PROFESSIONAL PET CARE SERVING THE UPPER VALLEY

Pet Sitting Services
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Contact Us

Email:
uvpc@uppervalleypetcare.com

Telephone:
603-291-3043

Phone Hours:
Monday-Friday: 8:00am-6:00pm
Saturday: 10am-4pm
Closed Sunday

Barnyard Pet Information

This is our Barnyard Pet Information Form, please fill out ONE FORM PER EACH PET. Unless it is a group of animals such as chickens. Please answer ALL questions and information completely.

Name of Primary Pet Owner: *

First

Last

Phone Number *

Email *

Preferred Method of Contact

Call
Text
Email

Name of Secondary Pet Owner:

First

Last

Phone Number

Email

Preferred Method of Contact

Call
Text
Email

Name of Pet: *

Type of Pet: *

Breed: *

Colors/Markings: *

Date of Birth: *

Sex: *

Is your pet spayed or neutered? *

Weight: *

How long have you had this pet? *

Did you get this pet as a: *

Is this pet microchipped: *

Health Information

General Health Information: *

Any history of, or current illness or disabilities with this pet? *

Are there any physical lumps, warts, skin tags, abnormalities, or other noteworthy things the pet sitter should be aware of? *

Is your pet current with vaccinations? *

Rabies Tag #:

Expiration Date:

Veterinarian's Name: *

Veterinarian's Phone #: *

List any medications/supplements including Name of meds, Dosage, What time it is given and How it is administered: *

Behavioral Information

How would you rate your pets general behavior? *

Excellent
Very Good
Good
Average
Poor
Challenging

In a few words, please describe your pets personality: *

How would you rate your pets energy level? *

Low energy
Average
High energy
Hyperactive

Has your pet ever bitten, scratched, or harmed another person? *

Yes
No

If yes, please explain:

Does your pet get along with new people? *

Has your pet ever had or currently has any aggressive behaviors? *

Is your pet afraid of anything? *

What motivates your pet? *

What is your pets favorite activity? *

Does your pet like to be handled? *

Can your pet be picked up? *

Is the pet allowed out of it's cage/enclosure? *

Are the animals confined at night? If so, where? *

Will the pet sitter have access to the house? *

Is there an alternative source of water? *

Are there heated water buckets? *

Is there electric fencing? *

Any other information that would be helpful for the pet sitter? *

Feeding & Care Instructions

Please answer each question below

Brand or type of pet food: *

Amount fed: *

How often? *

Rouphage? *

Usual feeding time(s)? *

Any medications/supplements? *

Treats? *

Food Allergies? *

Special Instructions:

Any areas of the house or yard that is off limits to your pet? *

Any other information for your pet sitter or dog walker?

Client Signature

I acknowledge that all of the information is complete, accurate and up to date to the best of my knowledge. I acknowledge that I have read and will adhere to the policies and procedures.

Electronically Sign Here *

Please type your full name

Date / Time *

Date

Time

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