Your Details

Your Name *

First Name

Last Name

Phone *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Species *

Dog

Cat

Rabbit

Guinea Pig

Indoor birds

Chickens

Reptile

Amphibian

Invertebrate

Fish

Exotic mammal

Hamster

Gerbil

Rat

Chinchilla

Degu

Ferret

Other pet

Is your pet neutered? *

Yes

No

What is the sex of your pet? *

Male

Female

Describe your pets personality *

Friendly and loves everyone they meet

Slightly nervous with new people

Grumpy or nervous with other animals

Full of energy

Calm and placid

Grumpy and doesn't like other pets

Does your pet have any medical issues? *

Yes

No

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####

Emergency Contact Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Vet's Contact Phone *

(###)

###

####

Veterinary Practice Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you consent to us taking your pet to the nearest vet in an emergency? *

Yes

No

Choose your service *

Dog walking

Exotic pet sitting (pop-in visits)

Companion pet sitting (pop-in visits)

I have read and agree to the Pythons & Poodles Pet Care Terms of Business and Service Agreement *

I agree

I would like to receive the Pythons & Poodles newsletter full of pet care tips, animal news, discounts and offers *

Yes please

No thank you