Western States K-9 College
Ph 801-703-3870
Western States K-9 College
In Home Pet Care
Registration
ADDITIONAL & EMERGENCY CONTACT INFORMATION
1. Scheduling and Visit times: We strive to accommodate the needs of your pet. WSK9CO provides a time interval during which visits will occur. If an unforeseen situation arises, the time interval may be adjusted.
2. Reservations: It is best to plan in advance in order to obtain services on the dates you desire. An in-home consultation is required, prior to reservations, for all new clients.
3. Reservation Confirmation: Please, do not leave town without directly confirming your reservations with WSK9CO.
4. Early Returns/Last minute Changes: WSK9CO carefully schedules our time to serve you and our other clients. Therefore, there are no refunds or credits for early returns or last minute changes to pet care.
5. Holiday Cancellations: With the exception of severe weather, life threatening emergencies or a death in the family, any cancellations over holiday periods will result in a 50% cancellation penalty of the total amount due.
6. Pet Sitting Cancellations: Outside of holiday periods, scheduled pet sitting services must be cancelled a minimum of 72 hours prior to the first scheduled service. Failure to provide 72 hours notice will result in a 50% cancellation penalty of the total amount due.
7. Additional Pet Care Assistance And Other Scheduled Services: WSK9CO does not accept liability for other persons who will be in your home prior to, during, or immediately after our services have been rendered. Please inform us at the time of the consultation of anyone who may have access to your home while you are away. This includes cleaning services, maintenance personnel, friends, family and neighbors. It is understood that the client will notify anyone with access to the home that the services of WSK9CO have been engaged.
8. Inclement Weather: You will entrust WSK9CO to use best judgment in caring for your pets(s) and home at the time of inclement weather. WSK9CO will try to carry out your instructions to the best of WSK9COʼs ability. Customer selection of a nearby emergency contact has been requested.
9. Inclement Weather Plan: 1) Every effort will be made to drive to your home; 2) The service schedule may be changed, interrupted, or altered due to circumstances; 3) If it is not possible to drive safely to your home, your emergency contact will be notified, 4) You will be notified that the above-mentioned contingency plan has been activated.
10. Inclement Weather Contact: Below, WSK9CO is requesting the name and phone number of a person living nearby (with access to your home). This should be a person close enough to walk to your home if roads are impassable (for example, a neighbor). If we are physically unable to drive to your home this information is needed so that we can contact this person to request their assistance to check on your pet(s). Please remember that garage door openers are not operational in the event of power outages. In the event that the customer does not provide a nearby emergency contact with access to your home for WSK9CO, customer realizes that WSK9CO will provide service but not until conditions allow us to reach your home safely.
11. Pet Guardianship: In the unfortunate event you become incapacitated while your pet(s) are in our care, please name the person(s) who should be contacted to become the guardian and take over the care of your pet(s) until care can be provided as arranged for in other legal documents prepared by you. We urge you to address care of your pet(s) when planning your estate. Please be sure the named person(s) is/are aware you are appointing the mas guardian(s) of your pet(s).
In the event of an emergency, which incapacitates me, I authorize WSK9CO to turn my pet(s) over to:
12. Medication/Vaccinations/Immunizations: WSK9CO will attempt to administer medications as directed but cannot be held responsible for complications that arise as a result. Under no circumstances will WSK9CO service any pet that has any form of active contagious illness. WSK9CO requires that all pets have the necessary vaccinations and immunizations before service begins. We may ask to see expiration dates for rabies vaccinations. If a WSK9CO pet care provider is bitten or exposed to any disease or ailment received from the clientʼs pet(s) which has not been properly or currently vaccinated, the client will be responsible for all costs and damages that may be incurred as a result.
13. Unforeseen purchases: WSK9CO will purchase pet food, litter, cleaning supplies or other necessary items that contribute to the health and wellbeing of your pet during your absence. We will retain a receipt and the pet owner is responsible for reimbursement of these items. In addition, a $15 trip fee will be applied.
14. Pet waste: WSK9CO will properly dispose of your pet(s) waste. We do request however, that you provide plastic bags for this purpose and indicate where you would like these waste bags disposed of.
15. Collars/Leashes: Please provide secure collars with appropriate tags for all visits. All dogs will be walked on leashes.
16. Fences: WSK9CO does not accept responsibility or liability for any clientʼs animals that escape or become lost or injured, fatal or otherwise, when instructed to leave the clients animals in a fenced area. This includes electronic, wood, metal or any other type of fence.
17. Other dogs: We will do our best to keep interaction with stray or strange dogs to a minimum.
18. House Cleanliness: WSK9CO will clean up after your pets to the best of our ability. Please inform us of the designated area for the appropriate cleaning supplies. WSK9CO is not responsible for carpet/flooring stains created by your pet(s). We request that you provide plastic bags, towels, cleaning products, paper towels, and trash bags. If there are accidents above and beyond the normal amount anticipated, WSK9CO will charge a reasonable fee for clean up time.
19. Thermostats: Please leave your thermostat settings within a normal comfortable range (68-78°F). If the house temperature is outside of this range, WSK9CO will adjust the thermostat to ensure the health and comfort of your pets.
20. Payment: WSK9CO accepts cash, checks and credit cards. Payment is due at the time of the in-home consultation unless otherwise agreed upon. Checks should be made payable to WSK9CO. All services are paid in advance.
21. Returned Check Charges: There is a $20.00 fee for all returned checks. Clients are responsible for all costs of collections.
22. Keys: WSK9CO will obtain two copies of your house key during the in-home consultation. One key will be held by the pet sitter. The other key will be coded for security and kept separately to be used only in the case of an emergency or lockout.
23. Key Retention: It is recommended that your keys remain in WSK9CO custody for convenience in future use of our service and to confirm services via telephone. Your keys will be kept in a secured lock system and are coded for your protection.
24. Key Pick-up/Drop-off: If you choose not to have WSK9CO retain your keys, key pick-up or drop-off will be at client's location.
25. Updates: Please inform us of any changes regarding your contact numbers, your petsʼ care needs and other pertinent information.
26. Privacy Policy: All of your information will be kept private and confidential. WSK9CO highly respects our clientsʼ entrusting us with the care of their home and pets.
By typing in my full name below, I am attesting to have read, understand and agree to the policies and guidelines of WSK9CO above. I further understand that a copy of this form will be kept for documentary purposes. All policies and guidelines are subject to change at the discretion of WSK9CO.
First Name
Last Name
Address
City
State
Zip
Phone #
Email
1.
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©2012, Western States K-9 College, All Rights Reserved.
Select Service
For how many dogs?
For how many cats?
Emergency Contact Information
First Name
Last Name
Phone #
Please note, this registration form is divided into the following four sections and should take 10-15 minutes for completion;
1) Household & Pet Information, 2) Addtional & Emergency Contact Information, 3) Veterinary Authorization, and 4) Agreement & Schedule of Services.
If at any time you have questions filling this out please contact Joe at 801.703.3870
Relationship
Household & Pet Information
Other persons who might be entering your home?
Name
Key to home?
Phone #
Note the following instructions, if applicable
Alarm/Gate Entry Password
Exit Password
Company Phone #
Code Word
Please list the location of the following:
Name
Key to home?
Phone #
Leashes
Toys
Carrier(s)
Food
Treats
Medication
Brushes
Broom
Doggie Towels
Electrical Panel
Fire Extinguisher
Trash Can
Any addtional items we need to know about?
Complimentary Service Instructions:
Bring in mail?
Alternate Blinds?
Water Plants?
Alternate Lights?
Turn on/off TV?
Turn on/off radio?
Alt Phone #
Company Name
Pet Information:
Dog Name
Dog Breed
Sex
Age
Frequency:
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ID Tags?
Feeding Instructions:
Spayed or Neutered
Quantity given at each frequency?
Example: 1 cup in the Morning and 2 in the Evening.
Special feeding instructions: Allergies, etc.
Medications:
Name of Medications?
When to administer?
Amount
How to administer?
Current on all vaccinations?
History of illness:
Please list and explain any history of illness.
Behavioral Information:
Has your dog ever snapped at or bitten anyone?
Is your dog good with children?
Has your dog ever bitten or fought another animal?
Should we approach with caution?
Does your dog have separation anxiety?
Does your dog like to play?
Does your dog like to exercise?
Does your dog like to be brushed?
2.
First Name
Last Name
Phone #
First Name
Phone #
Last Name
Type your full name here
VETERINARY & URGENT TREATMENT AUTHORIZATION
To whom it may concern: I have contracted for services from WSK9CO during my absence and I authorize WSK9CO to act on my behalf to request veterinary treatment and services when they deem it necessary.
During my various absences, WSK9CO will be caring for my animal(s). They have my permission to transport them to and from your office or request "on site" treatment from your office as is deemed necessary. I authorize you to treat my animal(s) and I will be fully responsible for all fees and charges and will pay for all charges incurred on my behalf upon my return. I further authorize you to give out any information about my animal(s) to WSK9CO or a representative of WSK9CO.
This form will be retained on file and will be used to authorize urgent veterinary treatment in the event that your pet(s) require such treatment during your absence and we are unable to contact you at the time. Should you change vets please notify WSK9CO before service dates.
3.
Type your full name here
AGREEMENT & SCHEDULE OF SERVICES
This e-signed document is an agreement between Western States K-9 College (“WSK9CO”) and (Client) for pet care services.
1. I authorize WSK9CO to perform pet care services as outlined above in the Household & Pet Information form, Policies and Procedures Form, and Veterinary Authorization Form which shall become part of this agreement.
2. I authorize WSK9CO to obtain any emergency veterinary care that may be necessary during the time spent with my pet. I accept responsibility for any charges related to this emergency care. I also authorize WSK9CO to utilize an alternative veterinarian in the event my primary veterinarian is unavailable. Every effort will be made to contact the owner prior to obtaining emergency care.
3. WSK9CO accepts no responsibility for security of the premises or loss if other individuals have access to the home before, during, or immediately after the term of this agreement.
4. I agree to reimburse WSK9CO for any additional fees for providing emergency care, as well as any expenses incurred for unexpected visits, transportation, housing, food, or supplies.
5. WSK9CO agrees to provide the services stated in this agreement in a reliable, caring and trustworthy manner. In consideration of these services and as an express condition thereof, the client expressly waives and relinquishes any and all claims against WSK9CO, its employees or represenatives, except those arising from proven negligence of the pet sitter.
6. WSK9CO will not be liable for the injury, disappearance, death, or fines of any pet with unsupervised access to the outdoors.
7. Customer will be responsible for all medical expenses and damages resulting from an injury to the pet sitter or other persons by the pet. Customer agrees to indemnify and hold harmless WSK9CO in the event of a claim by any person injured by the pet.
8. WSK9CO reserves the right to terminate this contract at any time, at its sole discretion; likewise, client may terminate this contract at any time as per the Information stated in Section 2.
9. It is expressly understood that WSK9CO shall not be held responsible for any damage to clientʼs property, or that of others, caused by clientʼs pets during the period in which they are in its care. Client has advised WSK9CO of all situations, which will relieve it of liability for damage.
10. Fees are earned upon acceptance of Agreement and are due at the time of or prior to the first visit.
11. I attest to the fact that all licenses and vaccinations required are current according to my local jurisdiction. (type initials here)
12. I authorize this contract to be valid approval for future services so as to permit WSK9CO to accept my telephone reservations and enter my premises without additional signed contracts or written authorization.
I have read and agree to the aforementioned Policies and Procedures, which are a part of this agreement. I am aware that I shall PRINT and keep a copy for my records PRIOR TO submitting this form.
By typing in my full name below, I am attesting to have read, understand and agree to this agreement in its entirety.
4.
Type your full name here
