Cat & Small Animal Booking Form

Owners Details

Name

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Phone

Emergency Contact Name & Telephone Number

Pet Details

Name

Breed

Age

Gender

Neutered

Microchip Number

Flea & Wormer Dates

Vaccinations Date

Upload Vaccination Proof

Click or drag a file to this area to upload.

Pet Insured

Pet Insurer

Policy No

Vet Name

Vet Tel Number

Vet Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Medical Conditions, History, Allergies, Current Medication

Behavioural Issues

Likes / Dislikes

Fearful, Anxious, Agressive Tendencies

Examples

Risk Asssess

Additional Animal Information

Total No of Cats / Small Animals From Same Household

Owner’s Permission Declarations

I as the owner of the aforementioned pet hereby give my full consent to the
following:

Permissons

I agree that in the case of suspected injury or illness to my cat / small animal a veterinary surgeon (vet) may be contacted for my pet to be examined, and investigations performed if required (blood tests, x rays but not limited to) and an appropriate course of action will be taken on advice of the vet.
I understand where possible any treatments will be undertaken by the cat / small animal ordinary vet but maybe otherwise at George’s Pet Pals (GPP) nominated vet, where that’s not possible.
I agree to GPP administering any prescribed treatment the vet considers advisable. I understand that the veterinary consultation, tests and treatment will be my own expense.
I also give consent for euthanasia should this be recommended on humane grounds by the vet caring for my cat / small animal of which GPP will be in communication with the owner.
I understand that every effort will be made to get in touch with me or my proxy (emergency contact) to discuss an appropriate course of action for my pet and GPP will endeavour to keep you and the proxy updated throughout the process of which all costs for the veterinary treatment & consultation will be at your own expense.
Permission to let out cat/small animal outside in the home environment / garden 15.2
I agree that if my cat / small animal has fleas or worms then GPP will take my pet to the vet to arrange an appropriate treatment and charge the vets bill to yourself (owner) 9.7
Permission granted for the use of images, photographs of my pet for social media, advertising purposes only.

Signature

Clear Signature

Date / Time

Date

Time

Key Holder Waiver

I as the owner of the aforementioned pet hereby give George’s Pet Pals access to my property (Keys, alarm codes, gate codes). I understand that these will be kept in the strictest of confidence, I also understand and agree by granting access to my property that George’s Pet Pals are not liable for any theft, loss or damage to the property or its contents. Refer to Terms and conditions item 20. George’s Pet Pals will return all keys on cancellation of its services and all codes will be destroyed.

Signature

Clear Signature

Date / Time

Date

Time

Emergency Asssess Licensee

Terms & Conditions

I as the owner of the aforementioned pet hereby have received and agree acceptance of George’s Pet Pals Terms and Conditions. I understand that these Terms and Conditions are binding and by signing this booking form they are deemed as agreed and accepted.

Signature

Clear Signature

Date / Time

Date

Time

Office Use Only

Accepted

Meet & Greet Date / Time

Date

Time

Meet & Greet Obervations

Interactions With Licensee

Additional Comments

Risk Asssess (copy)

Cat & Small Animal Booking Form