Holly’s Honeys New Client Forms

  Honeys New Client Forms- PDF

For your convenience, we’ve created the forms in two ways. Below you’ll find a scrolling list of the forms required for service. You can either copy & paste the text below into an email for: Holly@HollysHoneys.com or—Download and Print the PDF link Above.

Holly’s Honeys Pet Parents 

Owner/Parent Name: ____________________________________________

Owner/Parent Name: ____________________________________________

Home Address: ____________________________________________________

____________________________________________________

Phone: ________________________

Alt. Phone: ________________________

Email: ___________________________________________________________

Alt. Email: ___________________________________________________________

Guest SSID- Name & Passcode for House Wi-Fi Connection:

Name: _____________________________________________________

Passcode: _________________________________________________

*If you have questions about this, don’t hesitate to ask, but please provide this information. It could be essential to my reaching you.

Describe Home Entry/Exit Protocols (i.e.: lockbox, keyless entry, alarm system, etc.) Specifics are necessary upon confirmation of services.

____________________________________________________________

____________________________________________________________

_____________________________________________________________

🔶🔶🔶

Authorization for Emergency Medical Treatment Form:

  • Veterinarian: ___________________________________
  • Office Location/Address:_________________________
  • ______________________________________________
  • Veterinary Phone: _____________________________________
  • List 2 Contacts in the case of an Emergency:
  • Name: ____________________ Phone: ____________________
  • Name: ____________________ Phone: ____________________
  • Pet Clients are SOLELY Responsible for All Medical Expenses 

  • I, the Client/Pet Parent Do Hereby Authorize/Give Permission to Holly Campana of Holly’s Honeys, to act on my behalf—as representative for my pet(s) in the event of a Medical Emergency.
  • Credit Card need be on File with above Veterinarian.
  • Client agrees to Holly’s additional fees in the event of unexpected emergencies.

Client Signature: _____________________ Date: ____________________

🔶🔶🔶

Pet History Form:

Pet Name: _________________Age: _______________________


Breed(s): __________________ Gender: _______________

  Coloring: ___________________

  • Please check all that apply below:

___Vaccines Current: incl.-flu shot 
 ___ Documentation Provided

___ If Cat: Indoor Only 
                 ___ Pet Access to Outdoors when alone

___ Pet Socialized 
                      ___ Pet ever Harmed or Bitten Another

___ Uneasy w/ other pets             
___ On Heartworm & Flea Preventative

*Medication(s): ________________________________________________________________________________________________________________________

  • Dosages: ____________________________________________
  • PRN: ______________________________

*****

Pet Name: _________________  Age: _______________________

Breed(s): __________________ Gender: _________________

Coloring: _____________________

Please check all that apply below:

___Vaccines Current: incl.-flu shot 
 ___ Documentation Provided

___ If Cat: Indoor Only 
                 ___ Pet Access to Outdoors when alone

___ Pet Socialized 
                      ___ Pet ever Harmed or Bitten Another

___ Uneasy w other pets               
___ On Preventative Heartworm & Flea

Medication(s): ________________________________________________________________________________________________________________

  • Dosages: ____________________________________________
  • PRN: ______________________________

Client(s) Signature: _____________________ Date: _______________

🔶🔶🔶

Behavior Disclosure Form:

     To Client(s):

  • Please list ALL unique qualities or behavior traits of your pet(s), so Holly can provide the best care.
  • Additionally, Share Specific Handling Instructions (i.e.) special leash accommodations, approaching animals, reactiveness:
  • ________________________________________________________
  • ________________________________________________________
  • ________________________________________________________
  • ________________________________________________________
  • ________________________________________________________
  • ________________________________________________________
  • ________________________________________________________
  • ________________________________________________________

Client(s) Signature: ____________________ Date: _________________

🔶🔶🔶

Holly’s Honeys Care Agreement Form:

Please list your pets’ name and type (dog/cat/etc.):

  • Client’s Pet 1 _____________ Menu Selection __________________
  • Client’s Pet 2 ____________   Menu Selection __________________
  • Additional Pet ____________ Menu Selection __________________
  • *Pets/Families with a Menagerie: We will work out your Personalized Care Agreement during our Initial 60-minute Complimentary Meet & Greet Session.
    • *If Additional Consultations are needed after the Meet & Greet—a fee will be incurred for my time.
  • Dates of Care: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
  • 
 Additional Notes: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Client’s Signatures: ______________________ Date: ________________

🔶🔶🔶

Risk and Liability Waiver Form:

Holly’s Consultation with the Pet Client/Parent(s) has been completed. Congratulations and Welcome to Holly’s Honeys! You have acknowledged your understanding of my responsibilities & services, as well as the pet sitting plans offered. You also agree, that during transport—in the unexpected event of a ‘messy situation’ such as throw-up or potty in the Holly’s Honeys transport vehicle—compensation will be provided to Holly’s Honeys for the clean up.

You, Holly’s Honeys Client/Parent(s) is aware there are other types of pet care available, and have chosen Holly’s Honeys as a unique alternative, whose services rendered are incomparable. Additionally, you understand Holly’s Honeys is Committed to providing the best possible personalized care for your pet(s), with the highest professional standards, insurance and safety precautions. Holly’s Honeys has been chosen to provide care for her Client’s pet(s) in their own home, thus maintaining consistency in routine—while also in a familiar, comfortable environment.

The Client has given/provided full disclosure to Holly’s Honeys regarding their pet(s) unique character traits, behavioral qualities; and handling instructions.

The Client understands that Holly of Holly’s Honeys creates a personalized schedule and routine accommodating each of her client/pet’s needs. Client accepts responsibility for payment of services based on written agreement & including any additional services agreed upon verbally, after initial signing. Client acknowledges their responsibility for payment when a cancellation is made, unless 3 days notice is provided. Likewise, in the unlikely event of Holly needing to cancel, no payment would be charged.

You the Client/Parent of said pet(s) has agreed to accept full responsibility for any damages or injuries to persons, property, or other animals caused by their pet(s) while they are in the care and control of Holly’s Honeys/ Holly Campana.

I/We are now informed of potential liabilities associated with any outside party caring for my pet(s).

Signed, The Client(s): _________________  ______________________

On Signing, I/We agree to hold harmless, Holly’s Honeys and Holly Campana, from any liabilities regarding the afore-mentioned.

Client(s) Signatures: __________________________     _______________________________  Date:_______________________

📫Email: Holly@HollysHoneys.com -or- h.campana@me.com

📞Cell Phone: (408) 963-8020

🔶🔶🔶

[www.HollysHoneys.com All Rights Reserved. Copyright 2000©]