Basic Information for Home Visits & the B & B
We will talk more when we get together, of course!
If you do not receive a confirmation within 12 hours of submission,
it means that I have not gotten your information - in spite of the "Success" notificaton you may have received.
Please email or call me (614/774-3472) if this happens. Please save your information.

Name:
Email:
Address:
City, State, Zip:
Home phone:
Work phone(s):
Cell phone(s):

Would you like to schedule:

Home visits?
Potty Breaks?
Overnight stays?
Kitty Visits?
Horse visits?
Bed & Biscuit visit?
 other?

Please Tell Me About Your Animal(s)
Name, age, breed, sex and anything else you think is important.
Make sure to let me know if there are any health issues -
especially if he/she needs medications, special diet, etc...

Home Visits
Overnights & Kitty & Barn Visits, too!

Will your Dog/s be:
walked on leash or
turned out into a fenced yard

Is your animal aggressive to other animals?
 yes no
humans? yes no

What dates would you like to schedule?
Times:

(Please let me know if the times are at all flexible.)

First visit date & time:

Last visit date & time:

Directions to your house:
 I will be coming from the Dublin & Fishinger Road area.

B & B Visits
For your dog, kitty, bird or ??

Is your dog or cat friendly with
other dogs? yes no unsure
cats? yes no unsure

Might your dog jump a 4 foot fence?
yes no

Is s/he allowed on the furniture?
yes no

Does s/he sleep with you?
yes no

Drop off date & time:

Pick up date & time:

Feeding Information
Unless your animal requires a special diet, we will provide food.
(We feed a human grade, chemical free, natural food.)
Please tell me about any restrictions,
food aggression, etc.

Anything Else I Need to Know
Things like special likes and dislikes, quirks, sleeping arrangements,
crating/confinement instructions, and
anything else you want to tell me!

Emergency Information
How may I reach you?
Your Vet's name & phone number:
Will you advise your vet that your animals will be
in the care of Pawsitive Energy?
yes no
Please authorize an amount that may be spent
in the event of an emergency: $
Friends &/or relatives I may contact:

Etc.
How did you find out about us? flyer grapevine ad web search
Would you like to be on our Natural Health for Animals email list? yes no
Did you find this form helpful? yes no
Please email me if you have any suggestions!

 


Animal Sitting & More
Hilliard, Ohio
614/774-3472
pawsitiveenergy@aol.com

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