New Client Reservation Form©
                                  Absolutely no parts of this form may be reproduced by other petsitters without written permission from I Care Petcare!

If you have already used my services and want to make reservations for additional services, use the Existing Client Reservation Form.

I am unavailable for service from midday on Thursday, July 8 through the PM visit on Thursday, July 15 (I am available for service at and before the AM visit on July 8 and at and after the AM visit on July 16). If the dates you need service overlap my unavailability, please fill out the reservation form for the dates/times I am available and obtain other care during the time I am not. Thank you very much!

I am not currently accepting new clients with dogs.

Use your TAB key to move from box to box. Do NOT use your enter key as pressing enter will submit your form prior to completion! Please
fill out the form completely (be specific, boxes are expandable). This form only needs to be filled out once; the information you provide will be
used for all future visits.  Please read the Services/Rates/Policies page prior to filling out this form.  Submission does not automatically
guarantee services can be provided.  I will email you within 24 hours to confirm availability. Please contact me if you have any questions.

A. INFORMATION ABOUT YOU
Your full name:     Street address):   City:    Zip:
Email:   Cell: (include area codes)  Home Phone:  
Approx. # times/year you will need me:    Name of referring vet, friend, or other source:     
 Who previously cared for your pets (neighbor, friend, family, prof. petsitter--if pro, list biz name)?:
Reason you no longer use the aforementioned:
B. INFORMATION ABOUT THE SERVICE YOU REQUIRE

Date and time of my first visit:   
Date and time of my last visit:   

When are you leaving your home (not flight time)?  
When are you returning to your home (not flight time)?  

Petsitting service:  Visit length: Number visits per FULL day:
Total # visits THIS trip: Rate per visit: Total amount due (include set-up fee) $
C. INFORMATION ABOUT YOUR PETS

Pet #1:  Name: Species/Breed ( Bird/Cockatiel) Description:   Sex:  Birth year:
Feeding instructions (Be VERY specific! Include exact amount of dry and/or canned, seed, veggies, and feeding times)
Medication (Be VERY specific! Include name of med, type (pill, liq, crm, shot), reason for med, times meds normally given, dosage
EACH time, and any tricks to giving it, etc:
Any other meds for this pet including ALL the info above:
Health concerns (other illness, lumps, eye discharge, injuries, limps.): Be specific.
Has "accidents" vomits hairballs play bites "escapes" through door  Where go if "escaped"
Other things I need to know about this pet (favorite activities, temperament, hiding places, etc):

Pet #2:  Name: Species/Breed ( Bird/Cockatiel) Description:   Sex:  Birth year:
Feeding instructions (Be VERY specific! Include exact amount of dry and/or canned, seed, veggies, and feeding times)
Medication (Be VERY specific! Include name of med, type (pill, liq, crm, shot), reason for med, times meds normally given, dosage
EACH time, and any tricks to giving it, etc:
Any other meds for this pet including ALL the info above:
Health concerns (other illness, lumps, eye discharge, injuries, limps.): Be specific.
Has "accidents" vomits hairballs play bites "escapes" through door  Where go if "escaped"
Other things I need to know about this pet (favorite activities, temperament, hiding places, etc):

More pets. List the same info as above for each additional pet (don't forget fish):
E. INFORMATION ABOUT YOUR VETERINARIAN 

Veterinarian, clinic, or hospital: Complete Address: Day phone:  After hours:
Names of pets treated here: I authorize vet expenses up to): $ Treatments you don't authorize/more  info.:  
I DO/do NOT authorize euthanization in extreme circumstances under vet advisement after reasonable attempts have been 
made to contact me.  If you have more than one vet, list here the same info for each one:

 Typed Signature:    Date:

F. INFORMATION ABOUT THE LOCATION OF SUPPLIES (BE SPECIFIC!)

ALL pet food/treats:  Meds: Carrying crate: Litter /box/scoop:
 Bags for waste: Paper towels: Cleaning solution (brand) for "accidents" Broom
AND dust pan/mop Anything else I might need: 

G. INFORMATION ABOUT THE CARE OF YOUR HOME

Check services you want: Alternate shades Alternate lightsBring in mailBring in paper Water inside plants (detailed instructions)
Other service (detailed instructions) Name/phone of who will shovel/salt:  

H. INFORMATION ABOUT KEYS/ALARM SYSTEM

All precautions are taken to ensure the safety of your home and pets.  Keys, alarm codes, and other  personal information is kept confidential
and under lock and key.  I am insured and bonded. 

Keys (check one).     I release my keys to you to retain for future services (may be revoked at any time and keys returned).
I will pick up my key from you after I return and I will deliver/pick up key for future visits (must have keys at least 4 days before visits).

Alarm.  Name of alarm company:  Phone(s):   
Instructions for turning alarm OFF  (include your access code if can't give temporary code): 
Instructions for turning alarm ON  (include access code if can't give temporary code): 

Others authorized to be in your home while you are away.
Name/phone: Reason: Hours/days:
Name/phone: Reason: Hours/days:
 
I. INFORMATION ABOUT YOUR EMERGENCY CONTACT PERSON

I must be provided with the name of someone local who is authorized to make decisions on your behalf related to your pet or your home. 
Let this person know s/he has been listed and the dates you will be gone. Name: Phone:

Under what circumstances do you want to be contacted:  Don't call Any question Missing pet Pet's health  House emergency 
J. ANYTHING ELSE I SHOULD KNOW ABOUT OR COMMENTS/SUGGESTIONS


 

K. HOLISTIC SERVICES

 Yes, I am interested in Reiki sessions for my pets in combination with these petsitting visits. I will fill out the separate
reservation form for that service (go to my home page, click Holistic Services, and follow the links).
L. SERVICE CONTRACT

 I have completely read and fully understand and agree to all information contained in:     Reservation Form Services/Rates/Policies    

Typed Signature    Date 
Upon completion, click the "submit" button below.  A "confirmation" page will appear that shows all the information you have submitted.
Be sure to print that page for your records, that is your copy of the reservation part of the contract. At the bottom of the confirmation page
is a link that says, "Return to Form."  When you click the link and return to your form, you will notice that your information has disappeared. 
This is because the form automatically resets after submission.  After reviewing the confirmation page, if you need to add more info, email me.

Within 24 hours of receiving this form, I will contact you to confirm my availability and to arrange a set-up meeting. If you have not heard from
me within 24 hours, please call 414-871-1851. Thank you for your time and effort in filling out this form.  I strive to provide excellent care and the
information you have provided will help me do just that.  Call or email if you have any questions or concerns as you are filling out this form. 
I look forward to serving you and caring for your pets.

                                      your completed form to me.        to clear your form WITHOUT submitting it.

          
                                                                                                                                                            I Care Petcare, All Rights Reserved
                                                                                            No parts of this form may be copied without the express written permission of I Care Petcare!