Your Name Home Phone Partner/Spouse Name Phone Cell Address Phone(best to reach you while you re away)

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Mervyn Harper
5 years ago
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1 Peace of Mind Pet Sitting Pet Sitting Contract & Profile Serving San Jose, CA and surrounding cities Phone: (408) **Please PRINT clearly in blue or black ink** **Fill in all applicable fields to the best of your knowledge** Your Name Home Phone Partner/Spouse Name Phone Cell Address Phone(best to reach you while you re away) EMERGENCY CONTACT In the event of an emergency, aside from yourself, who is authorized to make a decision if your are unreachable? HOME VISITORS Should we be expecting anyone in your home during your absence? Y / N If yes, Please provide authorized visitor s information HOME SECURITY For key returns, please circle your preferred method: 1. Deliver in person 2. Mail to you at your home address ($10 charge will apply) Will an alarm system be set? Y/ N Alarm System Panel(s) location *Alarm system information will be discussed in person Alter lights/blinds? Y / N Turn on TV/Radio? Y / N

2 PET PROFILE *If you have more than one pet please print the additional pet form for each and every additional pet Pet s name: Dog / Cat / Other Age/Birthday: Male / Female Spayed / Neutered / Neither Breed: Color: Collar Color: Tags: Y / N Micro-chipped: Y / N Favorite toys/games Feeding instructions Major Medical Conditions (past or present) Medications (name, dosage, frequency) Has your pet ever been aggressive towards anyone in the past? Walking/Play time and exercise instructions Restricted Access (Rooms or Furniture) Will your pet be crated at any point during our service? This pet loves to This pet does not like to Special handling (ex.:deaf/blind, Object guarding, food aggression, dog aggression, storm anxiety, separation anxiety, hiding places, fears/phobias, etc.) _ Other Notes:

3 Please let me know where the following items will be located during the scheduled sitting and any applicable instructions: Leash: Treats: Food: Food Bowl: Medication: Litter Box: Cat Litter: Pet Carriers for Transport: Pet Waste Disposal: Carpet Cleaner and Rag: Towels to Wipe Pet if Raining: Fire Extinguisher: I do hereby waive and release Peace of Mind Pet Sitting from any and all liabilities of any nature for the actions of myself, my pet(s), or any other person who accompanies me, or holds a key to my home; except those arising from negligence or willful misconduct on the part of Peace of Mind Pet Sitting. Peace of Mind Pet Sitting agrees to provide all services in a kind, reliable, and trustworthy manner. In the case of an emergency, inclement weather, or a natural disaster I authorize Peace of Mind Pet Sitting to use their reasonable judgment for the care and wellbeing of my pet(s) and/or house. I understand that Peace of Mind Pet Sitting reserves the right to refuse service to any client, at any time, for any reason. I attest that all of the above information is true to the best of my knowledge. If anything changes from what is listed above I will inform Peace of Mind Pet Sitting before the next service is scheduled to begin. This signed document gives Peace of Mind Pet Sitting authorization to enter the above listed address as needed to perform the necessary pet sitting services as listed in this contract. I authorize this contract to be valid approval for services as to permit Peace of Mind Pet Sitting to accept all future telephone or reservations and enter my home without additional signed contracts or written authorizations. Signed Name X Date: Printed Name X **Peace of Mind Pet Sitting will collect this original form at the time of the pre-service visit. A copy will be ed to the listed address prior to the first scheduled sitting.

4 VETERINARY MEDICAL CARE RELEASE FORM In the event of a medical emergency where Peace of Mind Pet Sitting cannot contact you to authorize care immediately and directly, Peace of Mind Pet Sitting will use this form to obtain care. Primary Veterinarian s Information Name of Vet Hospital or Clinic: Address: Phone: Name of preferred doctor: I, (pet owner) hereby give Peace of Mind Pet Sitting permission to transport any of my pets for care to the above listed veterinarian (Or to the closest open facility if the primary vet office is not available). I give permission for the hospital/clinic/doctor to administer any care or medications necessary. I understand the Peace of Mind Pet Sitting will try to contact me as soon as possible in the event of a medical emergency. If Peace of Mind Pet Sitting cannot contact me, I give permission to Peace of Mind Pet Sitting to approve treatment up to $ Per pet. I will assume full responsibility for the payment and/or reimbursement for any and all veterinary services rendered, including but not limited to diagnosis, treatment, grooming, medical supplies, etc. Such payments will be made over the phone directly to the veterinary hospital if I am reached by phone before Peace of Mind Pet Sitting leaves the premises, or within 5 days of scheduled return date. I also agree to be responsible for any and all special service fees assessed by Peace of Mind Pet Sitting for emergency transportation, care, or supervision, and will pay such fees within 5 days of scheduled return date. In the event that my pet goes into Cardiopulmonary Arrest, I authorize CPR to be performed: Y / N List of Pets: Signed Name X Date: Printed Name X

5 Terms and Agreements *Same as listed on our website, no changes have been made to this document. For every sitting request, and before the first scheduled start date, a completed and signed client packet will be required. A meeting between myself and pet owners should be scheduled prior to first start date of scheduled sitting to turn in client packet and payment. This allows us to go over house rules, feeding times, etc. Payment is due in full at time of scheduled meet prior to first start date of scheduled sitting. (Payment methods include cash or check. There will be a $20.00 service charge for any returned checks. Credit card payment not accepted at this time.) Administration of medication will have an extra charge. A cancellation fee will be assessed for any cancellations received less than 48 hours prior to scheduled sitting. clients returning home early will be required to pay for the reserved amount of time scheduled. Clients will not have to pay for scheduled Medication Administration not given. Peace of Mind Pet Sitting is not responsible for wilted, dead or otherwise unhealthy plants. Peace of Mind Pet Sitting will work hard to follow your written directions as precisely as possible, but cannot be responsible if the results are not favorable. Please place all indoor plants together on a waterproof surface in plain sight, as your pet sitter is not responsible for water damaged areas or missed plants. Peace of Mind Pet Sitting is not responsible for damage to the home beyond the control of the Pet Sitter. This includes, but is not limited to leaks, electrical problems, and acts of nature. In these situations, we will attempt to contact the customer and then the emergency contact before making a subjective decision on dealing with the problem. All repairs and related fees (including Special Service emergency service time and coordination fees) will be paid by the client, or fully reimbursed to Peace of Mind Pet Sitting within 14 days. Peace of Mind Pet Sitting is not responsible for any damage to property of the client or others unless such damage is caused by the negligent act of the Pet Sitter. Peace of Mind Pet Sitting accepts no responsibility for security of the premises or loss if other individuals have access to a client s home, or if the home is not properly secured. Peace of Mind Pet Sitting is not liable for any loss or damage in the event a burglary or other crime that should occur while under this contract. Pet Owner agrees to secure home prior to leaving the premises. Peace of Mind Pet Sitting will re-secure the home to the best of its ability at the end of each visit. While keys are in the possession of a Pet Sitter, they will be either on the Sitter s physical person, or be properly stored in an undisclosed location. Pet Owner is responsible for pet-proofing house and yard, and the security fences/gates/latches. Pet Owner is responsible for supplying the necessary, safe equipment/supplies needed for care of their pet(s), including but not limited to a sturdy, well-fit harness (halter, collar, etc ) for walks or in case of emergencies, pooper-scoopers, litter boxes, food, cleaning supplies, medicines, pet food, and cat litter. Pet Owner authorizes any purchases necessary for the satisfactory performance of duties. Pet Owner agrees to be responsible for the payment of such items, as well as service fees for obtaining items, and will reimburse Peace of Mind Pet Sitting within 14 days for all purchases made. Pet Owner will be responsible for all medical expenses and any damages resulting from an injury to a Pet Sitter, by the Pet. Customer agrees to indemnify and hold harmless, and defend Peace of Mind Pet Sitting, in the event of a claim by any person injured by the Pet. Client agrees to notify Peace of Mind Pet Sitting of any concerns with their pet within 24 hours of return. Signed Name X Date Printed Name X

Thank you for choosing C & G Pet Sitting!

Thank you for choosing C & G Pet Sitting! Owner Information Date Name Phone Address City Zip E-mail May I contact you with e-mail updates? Yes No How did you hear about us? Pet Information (additional