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Pet Care Request Form

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PET CARE REQUEST FORM AND SERVICE AGREEMENT

Parties and Recitals

This Pet Care Request Form and Service Agreement (the Agreement) is entered into between Owner Name: and Care Provider Name: .

WHEREAS, Owner is the lawful custodian of the pet(s) described below and desires to engage Provider to perform pet care services as set forth herein; and

WHEREAS, Provider represents that Provider has the necessary experience, training, and resources to provide pet care services and agrees to perform such services in accordance with the terms of this Agreement; and

WHEREAS, the parties intend that this Request Form sets forth both the requested care instructions and the binding terms controlling the provision of services.

Owner and Contact Information

Pet Information

Species:

Breed:

Age:

Sex:

Services Requested & Schedule

Select requested services (check all that apply):

to

Feeding and Medication Instructions

Veterinary & Emergency Contacts

Authorization to obtain emergency veterinary care if Owner cannot be reached:

Maximum authorized emergency expenditure without prior owner approval: $

Access, Keys, and Property

Access method (check one):

Scope of Work

Describe the scope of services Provider will perform. This description shall control the services to be provided unless amended in writing by the parties.

Payment Terms

Owner agrees to pay Provider as follows.

Owner is responsible for payment of services, any emergency veterinary expenses (up to the authorized limit), and any fees for lost keys or missed visits as defined above.

Term and Termination

Term Start Date: Term End Date:

Either party may terminate this Agreement upon written notice to the other party at least days prior to the effective termination date. Provider may terminate immediately for safety concerns or non-payment.

Confidentiality

Provider acknowledges that certain information about Owner and Owner's residence may be confidential. Provider agrees not to disclose Owner's contact information, security codes, or proprietary instructions to third parties except as required to provide services or as required by law. This obligation survives termination of this Agreement for a period of two (2) years.

Liability, Indemnity, and Authorizations

Provider will exercise reasonable care in performing services. Owner understands and accepts that no care provider can guarantee against injury, illness, escape, or other unforeseen events. Owner releases Provider from liability for ordinary negligence in providing non-medical services, except in cases of gross negligence or willful misconduct. Owner shall indemnify and hold Provider harmless from claims, losses, or expenses related to Owner's negligence or misrepresentation of pet medical history.

Owner authorizes Provider to transport pet(s) to the named veterinarian or emergency veterinary facility if urgent care is necessary and Owner cannot be reached. Owner agrees to reimburse Provider for reasonable emergency expenses up to the maximum authorized amount set forth above, and to promptly remit payment for such expenses.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State specified by the parties below. Any action to enforce this Agreement shall be brought in the courts of the jurisdiction identified by the parties.

Entire Agreement

This Agreement, including all attachments and the information provided in this Request Form, constitutes the entire agreement between Owner and Provider with respect to the subject matter herein and supersedes all prior negotiations, representations or agreements, whether written or oral. Any modification must be in writing and signed by both parties.

Owner Certifications

By signing below, Owner certifies that the information provided in this form is true and accurate to the best of Owner's knowledge, that Owner is the lawful custodian of the pet(s) identified, and that Owner has the authority to authorize the services described herein.

Owner:

By:

Date:

Care Provider:

By:

Date:

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What the Pet Care Request Form Is and when it’s used

A Pet Care Request Form is a written record used by pet owners to authorize and instruct a pet care provider, sitter, groomer, or veterinary clinic about routine care, special needs, access, and emergency instructions. It collects owner and pet details, vaccination and medical information, medication schedules, house access directions, preferred communication channels, and emergency contacts. The form can be paper-based or completed and signed electronically; when used electronically it should meet ESIGN/UETA requirements for signature intent, consent, attribution, and durable record retention to be legally enforceable.

Why having a clear Pet Care Request Form matters

A well-completed form reduces miscommunication, documents permissions for care and medical treatment, and clarifies liability and payment expectations. It provides providers with the exact information they need to care for an animal safely and supports dispute resolution if questions arise.

Why having a clear Pet Care Request Form matters

Typical users and contributors

People and organizations that use this form range from individual pet owners to professional care providers; each role has different completion responsibilities.

  • Pet owner — completes owner, pet, medication, access, and emergency-contact sections before handing the form to the provider.
  • Pet care provider — reviews instructions, confirms acceptance, documents any exceptions, and retains a signed copy during the care period.
  • Veterinary clinic or emergency hospital — uses the form for treatment authorization, billing contact, and to confirm vaccination and medical history.

Accurate completion by all parties helps ensure safe animal care and creates a clear record of permissions and instructions.

Step-by-step: completing and delivering the form

Follow a predictable sequence to minimize omissions and make the form usable during care.

  • 01
    Fill owner details: Enter full name, address, and contact numbers.
  • 02
    Provide pet health data: Record vaccinations, allergies, medications, and vet contact.
  • 03
    Authorize treatments: Specify limits for medical decisions and emergency care.
  • 04
    Sign and share: Sign, date, and deliver the form to the provider before care begins.

Configuring an online Pet Care Request Form workflow

Set up a simple digital workflow so owners can complete, sign, and return the form securely before service begins.

Field | Configuration Required | Conditional
Notification method Email with optional SMS reminder
Authentication Email link or SMS code for signer verification
Conditional fields Show medication fields only if 'Yes' selected
Storage location Secure cloud folder with audit trail

Where to submit the completed Pet Care Request Form

Choose a submission path that matches the provider’s intake processes and preserves a signed record.

  • Email to provider: Send a signed PDF to the provider's official business address.
  • Upload to portal: Use the provider's secure intake portal or client dashboard.
  • Deliver in person: Hand a printed signed copy at drop-off or meet-and-greet.
  • Attach to booking: Link the signed form to the reservation or client account.

Digital submission and format requirements

Use common file types and secure channels so providers can open and archive the form without extra steps.

  • File formats: PDF or DOCX are preferred for compatibility.
  • Storage security: Encrypted cloud storage with access controls.
  • Integrations: CRM, calendar, and client portals supported.

Ensure the chosen platform captures a signing audit trail and stores a durable copy to meet recordkeeping needs.

Essential sections to include in a professional form

A comprehensive form organizes owner, pet, medical, and administrative details so providers can act quickly and consistently.

Owner contact

Full legal name, primary phone, secondary phone, email, and physical address for billing or emergency pickup.

Pet profile

Name, breed, age, weight, microchip number, and distinguishing features for positive identification.

Medical history

Current medications, allergies, chronic conditions, last vaccination dates, and preferred veterinarian contact.

Care instructions

Feeding schedule, exercise needs, behavioral notes, and permitted activities during care period.

Emergency authorizations

Clear authorization scope for emergency veterinary care including monetary limits and preferred clinics.

Signatures and dates

Owner signature, date, and provider acknowledgment to confirm acceptance and terms of care.

Core information fields every form should capture

Owner phone: Primary contact number
Emergency contact: Alternate local contact
Pet ID: Microchip or tag number
Vaccine status: Date of last vaccinations
Medications: Names and doses listed
Access notes: Key code or neighbor contact

Common mistakes to avoid when preparing the form

  • Omitting emergency contact details or providing contacts who are unavailable during the care period creates delays and risks for urgent treatment.
  • Vague medication instructions or missing dosages lead to administration errors and potential harm to the animal during care.
  • Failing to document authorization limits for veterinary care can expose providers to liability or result in delayed treatment.
  • Not supplying a current vaccination date or certificate may cause refusal of services at facilities that require proof.

Consequences of an incomplete or incorrect Pet Care Request Form

Service refusal: Provider may decline care for missing vaccinations
Delayed treatment: Ambiguous authorization can slow emergency care
Liability gaps: Unclear permissions may shift responsibility in disputes
Billing disputes: Missing payment terms complicate invoicing
Legal exposure: Unauthorized care decisions risk claims
Record inconsistencies: Mismatch in IDs hinders pet recovery

Timing expectations and key deadlines

Set clear timeframes in the form and confirm them with your provider to avoid scheduling conflicts or service denials.

Submit before start:

Provide the signed form at least 24–72 hours before care.

Cancellation notice:

Specify required notice (commonly 24–48 hours) for deposits or fees.

Vaccination updates:

Supply proof of current vaccinations prior to first service.

Medication changes:

Notify provider immediately of any medication adjustments.

Record updates:

Update contact and health info whenever changes occur.

Key milestones from request to post-care

A simple milestone sequence clarifies responsibilities at each stage of care.

01

Request submitted

Owner completes and signs the form and sends it to the provider.

02

Provider confirms

Provider reviews, requests clarifications, and confirms acceptance.

03

Care period

Provider follows instructions and documents any incidents.

04

Post-care follow-up

Provider returns signed copy and reports health or billing notes.

Real-world example scenarios

Two practical scenarios show how the form is used and why complete information matters for safe care and straightforward billing.

Neighborhood pet sitter

An owner completing the form before a week-long trip ensures medication timing is clear

  • Pet sitter confirms receipt and documents medication logs
  • The signed form and daily notes prevent disputes and allow timely veterinary care if an issue arises, reducing risk and ensuring accountability.

Veterinary boarding facility

A clinic requires a completed form at drop-off to accept an animal for boarding

  • Staff verify vaccines and medication instructions against the form
  • Maintaining a signed form joined to the patient record expedites treatment authorizations and simplifies billing after an incident or emergency visit.

Practical tips for accurate and efficient completion

Small habits improve form reliability and reduce follow-up questions from providers.

Use clear, consistent formats
Enter dates as MM/DD/YYYY, write phone numbers with area codes, and avoid abbreviating medication names to reduce administration errors and ensure consistent recordkeeping.
Attach supporting documents
Include vaccination certificates, medication labels, and microchip registration copies so providers can verify critical data without back-and-forth.
Document authorization limits
Specify precise monetary caps and provider preferences for emergency care to prevent unexpected bills and align provider actions with owner expectations.
Maintain version control
When updating information, mark the revision date and maintain previous signed versions for incident investigations and continuity of care.

eSignature vendor comparison for completing and signing the form

Comparing provider pricing and key capabilities helps organizations choose a signing solution that meets security and volume needs. signNow is listed first per vendor comparison conventions.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial, no credit card required Varies by vendor Varies by vendor Varies by vendor Varies by vendor
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No envelope cap 100 envelopes/user/year Varies Varies Varies

Frequently asked questions about the Pet Care Request Form

Answers to common questions about validity, signatures, changes, and storage for the Pet Care Request Form.


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