Client Information Form

Client Information

Name:_________________________________________ Phone: __________________________

Address:_______________________________________ Alt. Phone: _______________________

______________________________________________ Email: ___________________________

Emergency Contact:______________________________ Emergency #:_____________________

Property Information

Securely Fenced: Yes No Notes:_______________________________________________

Invisible Fence: Yes No Notes:_______________________________________________

Pet Door: Yes No Notes:_______________________________________________

Preferred Entry: _______________________________________________________________________

Location of emergency shut off: Gas___________ Water ______________ Breaker Box _____________

Security System: Yes No

Company:_______________________ Phone:___________________ Code: __________________

Password:_______________________ Door Entry:_______________

Arming Instructions:____________________________________________________________________

Disarming Instuctions:__________________________________________________________________

Location of cleaning supplies:_____________________________________________________________

Will anyone else be on your property, please include names and times:
_______________________________________________________________________________

Service Preferences

Key Release: Leave upon final visit Keep for future use Mail

Communication Preference: Text Daily Log Phone Call

May we use your pets photo for marketing: Yes No

Payment Method: Cash Check PayPal

**Payment expected within 5 days of completed service.

Service Agreement
This agreement is effective from ___________ to ___________ and is between James The Dog Guy and

_________________________ . This agreement constitutes permission to enter above address and

perform duties as outlined below and on pet information sheet.

Service for (list pets): ___________________________________________________________________

Preferred Times for visits, if the same for each day of the week please only complete one.

Sunday:______________________________________________________________________________

Monday:_____________________________________________________________________________

Tuesday:_____________________________________________________________________________

Wednesday:___________________________________________________________________________

Thursday:_____________________________________________________________________________

Friday:_______________________________________________________________________________

Saturday:_____________________________________________________________________________

Additional services: Mail/ Paper Plants Trash Turn on/off lights

Other:________________________________________________________________________________

Rates

10 visit package rate ($14.4/visit) Vacation/ Multiple Day Rate ($55/day)

Single visit rate ($16) Other:________________________________________