Wakey Walkies

Customer Dog Sitting, Walking and Boarding Form

Once you've had a home visit, agreed on dates and costs you'll need to complete the online form below Please only complete this from if you have had a success trail visit and have made a booking or you are a returning customer!

PLEASE NOTE : This can take 15 - 25 mins so please make yourself comfortable, unfortunately all sections need completing so please first familarise yourself with the information. The local authority WMBC require that I document this information! Please fill the form in online below its Eco-friendly and no printing costs...but if you really want to Click the button to print the current page

Click To Print page

1. Name *
2. Email *
3. Mobile Phone *
4. Pets Home Address *
5. Pets Age (s) in years *
6. Pet (s) Breed / Description *
7. Gender *
   Male Female
8. Arrival date *
   -DD- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 /  -MM- 01 02 03 04 05 06 07 08 09 10 11 12 /  -YYYY- 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032
9. Departure Date *
   -DD- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 /  -MM- 01 02 03 04 05 06 07 08 09 10 11 12 /  -YYYY- 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032
10. Service required *
    Day care Dog Sitting Day Care and Dog sitting Other
    
11. Vets Name *
12. Vets Address *
13. Vets Telephone number *
14. N.B. You will need to inform the Vet I'm looking after your dog or they may not deal with me! Please confirm you have spoken to your Vet *
    Yes
    
15. Name of emergency contact (s) *
16. Emergency Number (s) *
17. Does your pet have insurance cover *
    Yes No Other
    
18. Policy number *
19. Contact Insurance number *
20. Firms Name *
21. Proof of current vaccinations, (PHOTOCOPIES REQUIRED) *
    Yes No Other
    
22. Date of last worming treatment *
    -DD- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 /  -MM- 01 02 03 04 05 06 07 08 09 10 11 12 /  -YYYY- 2017 2018 2019 2020 2021 2022 2023
23. Last Flea Treatment *
    -DD- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 /  -MM- 01 02 03 04 05 06 07 08 09 10 11 12 /  -YYYY- 2017 2018 2019 2020 2021 2022 2023
24. Is your dog Micro chipped (NUMBER REQURIED) *
    Yes No Microchip number
    
25. In an area such as a dog friendly park, is your dog allowed to be let of the lead? *
    Yes No Other
    
26. Is your dog friendly with other dogs and people? *
    Yes No Other
    
27. How many times a day is your dog fed *
28. and at what times *
29. What dietary requirements does your dog have i.e. what can they eat or not eat *
30. Please note: The dog owner supplies the food for the dog during the stay  
    Yes
    
31. Is it OK to give your dog treats? *
    Yes No Other
    
32. How many walks a day does your dog usual have.. (Dogs are usually walked a minimum of twice per day) *
33. ......and for how long (Usually around 30 mins) *
34. Tailored activities can be catered for for example for a minimum of twice per day, dog play, grooming, indoor play, toys, treat toys, and socialising other dogs, this can be beneficial for dogs who cannot be part of a regular walk *
35. Is your dog OK to settle in a shared room if happy and content around other dogs *
    Yes No Other
    
36. Where does your dog sleep on a night? *
37. All dogs could have accidents but is your dog usually fully house trained? *
    Yes No Other
    
38. Is your dog known to chew or scratch anything if so please specify *
39. Has your dog ever been known to jump fences or dig underneath? *
40. Please give brief details of any relevant past or current medical history *
41. Does your dog have any medical problems/allergies or on any medication? *
    Yes No Other
    
42. If yes what medication/dosage and times *
43. Is it OK for your dog to be left for short periods of time in the house? *
44. Has your dog been neutered or spayed? *
    Yes No
45. Please list anything you think I need to know about your dog (s) *

46. TERMS AND CONDITIONS

    You agree all the information above is accurate and you have opted in to me being able to use this information for the welfare of your dog, please see Privacy section for full details on how I use your personal data www.wakefielddogwalking.co.uk/gdpr.html

    The pet Owner (s) agrees to release Wakey Walkies from any liability that may arise as a result of damage to property, injury to or death of pets.

    Pet owner (s) will be held responsible for any injury or damage caused to Wakey Walkies property as a result of previously undisclosed behavior in any of owners pets. Pet Owner and Wakey Walkies agree that this contract is subject to the laws and regulations

    Even if they are from the same owner the pet owner (s) consent to isolate the dog (s) if in the unlikely event they become anxious or aggressive, until their behavior suits reintegration.

    If the dog (s) exhibit signs of disease, illness, internal or external parasites the pets owners authorised Wakey Walkies to seek Veterinary advise and medication at the pet owners expense regardless of previous treatment dates or no prior signs of infestation

    The pet owners consent to Wakey walkies transporting dog (s) in a motor vehicle in a crate or dog harness/seat belt for recreation or Veterinary needs

47. Tick to agree to the terms and conditions stipulated above  
    Yes
    
48. Full name of person e-signing  
49. 16 March, 2019 12:17 PM
50. Any other information we need to know?  
51. Security Code: *
    Reload Image
    
52.  
    Please check the required fields