NEW DOG WALKING INQUIRY/ENROLLMENT:

NEW DOG WALKING ENROLLMENT FORM

**NEW CLIENT INQUIRIES**
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*if you've already spoken with us, please scroll down to the form below*

COVERAGE MAP!

* Indicates required field

Owner Name *

First

Last

Home (000-000-0000) *

Cell (000-000-0000) *

Email Address *

Secondary Owner Name *

First

Last

Secondary Owner Cell (000-000-0000) *

Secondary Owner Email address *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Inquiry *

Dog Walking SOLO Dog Walking *Additional Information Needed Below Puppy Visits Pet Sitting (In-home)

*Reason for requested SOLO walk(s) *

Service(s) requested *

Daily Walks (Monday-Friday, 5 per week) On-Call Walks (as needed) Daily Walks (4 or less per week) Daily Walks (more than 5 per week) Pet Sitting (In-home) Various needs, undecided at this time

Service start date mm/dd/yy *

Specific time request, beyond 10:00am or 7:00pm, weekend or holiday request *

Emergency Contact Name *

First

Last

Emergency Contact Phone (000-000-0000) *

Does Emergency Contact have keys or access to your home? *

Yes No

Veterinary Clinic *

Name of Doctor *

Clinic Address *

Veterinary Clinic Phone (000-000-0000) *

Dog Name *

DOG PHOTO UPLOAD *

Max file size: 20MB

Dog Breed *

Birthday (mm/dd/yy) *

Sex *

Male Female

Altered *

Yes No

Color *

Weight *

Check all that apply (leave comments below if necessary) *

Comments & Issues *

Leash/Collar/Harness Location *

Food/Treats Location *

Dog #2 Name *

DOG #2 PHOTO UPLOAD *

Max file size: 20MB

Dog #2 Breed *

DOG #2 Birthday (mm/dd/yy) *

Dog #2 Sex *

Male Female

Dog #2 Altered *

Yes No

Dog #2 Color *

Dog #2 Weight *

Dog #2 Check all that apply (leave comments below if necessary) *

Dog #2 Comments & Issues *

RESPONSIBILITY (you must check each box) *

You agree to supply two sets of keys to your home at your initial consultation. You agree to supply a 4' nylon or leather leash ready for Little Dipper's first walk. (Little Dipper does not walk with retractable leashes, chain leashes, or leashes longer than 4'). You agree to supply a flat nylon or leather collar with ID tags ready for Little Dipper's first walk. You authorize us to perform the services outlined in this agreement. You also authorize us to seek any medical care if deemed necessary with release from all liabilities related to transportation, treatment and expense. You authorize us to approve medical and/or emergency treatment (excluding euthanasia) as recommended by a veterinarian in the event of an emergency. Client agrees to reimburse sitter for any expenses incurred attending to this need. You agree to not hold us responsible to any injury caused to pet, sitter or general public due to the pet being off-leash at owner’s permission in the agreed upon areas during the agreed upon times. i.e.: Dog Park In the event of inclement weather, acts of terror or natural disaster, you trust us to use our best judgment in caring for your pet(s) and home. We will be held harmless for any consequences related to such decisions. You are responsible for any costs/payments incurred by the sitter due to bites, exposure of ailments and/or diseases by the owner’s pet(s) in which they were not properly vaccinated.

TERMS & POLICIES (you must check each box) *

INITIAL CONSULTATION/KEYS: New dog walking clients will receive an initial consultation free of charge. During this time we will meet with you and your pets(s). We will gather information from you about your pet’s regular routine so that we can provide the best possible care to your pet(s) while you are away from home. Pet shuttle clients we will meet with at the time of the first ride. We will review this agreement, including key options and emergency contact information. We will explain our services and answer any questions you may have. We will collect two sets of keys from you. We prefer to retain your keys on file for future services or those last minute needs you may have; however, in the event you want your keys returned, an additional $16.00 pickup/dropoff fee will apply each time a service is needed. We will not leave your keys inside your home, in case you are delayed in returning and your pet needs further care. REQUESTS: Must be made a minimum of 24 HOURS in advance for returning clients and 5 days in advance for new clients. Last minute requests are taken on a case by case basis for established clients only. *Additional fees may apply. CANCELLATIONS: Cancellations for all services must be made a minimum of 24 hours prior to scheduled service. You will be charged for any scheduled visits that fall within a 24 hour period of cancellation. *ALL SALES ARE FINAL. NO REFUNDS PROVIDED. PAYMENT: Full agreed upon payment will be automatically charged through your payment portal "PetPocketbook" with your saved method on your account created when you sign up with Little Dipper. It will be due/charged at the end of the current agreed upon billing cycle and will include any additional fees such as cost of supplies, transportation, etc. Through PetPocketbook, e-check is the preferred form of payment, or you may use any credit card as well. If using a debit card, please use the "e-check" method instead of a credit card number. You may also leave cash or a check made out to: Little Dipper, Inc. Payments for regularly scheduled daily pet care visits can be paid weekly or monthly (to be agreed upon at first meeting). If payment is not received for two consecutive weeks, walks will be suspended until full payment is received. *There is a $25.00 fee for returned checks. SICK PETS: Should be under the supervision of a professional veterinarian. We will not schedule walks/visits to pets who are known to be ill; however, we will gladly provide service to pets who simply require medication or have special requirements, such as elderly pets. PRIVACY POLICY: We do not share your information with any third party, with the exception of PetPocketbook for the purpose of setting up your client portal.

PROMOTIONS (you must check box) *

You grant Little Dipper permission to use any pictures taken of my dog(s) for business-related activities. You understand that this use may include advertising and marketing campaigns, website images, and other uses for promoting the services of Little Dipper.

*OTHER (Please be as specific as possible) *

Agreement *By signing this contract and leaving my pet in Little Dipper’s care, I certify the accuracy of all the information I have provided to Little Dipper relating to my pet. *

I agree to the above statements (All Terms, Policies, Responibility & Promotions boxes must be checked)

Client Signature (Full name) *

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WALKING & GENERAL email:
contact@littledipperpetcare.com