Pet and Pony Care Instructions

1.)Pet/Equine Name:		Species :
Breed :	Color :	Sex :
2.)Pet/Equine Name:		Species:
Breed:	Color:	Sex:
3.)Pet/Equine Name:		Species:
Breed	Color:	Sex:
4.)Pet/Equine Name:		Species:
Breed:	Color:	Sex:
Any Aggressive History, If Yes Explain:
Any Health Problems:
Secure In Home/Yard:

Contact Information:

Name:		Email:
Address :
Home Phone:	Business Phone:
Cell Phone:	Alternate Phone:
Emergency Contact:	Emergency Phone:
Date/time Leaving:	Date/Time Expected Home:
Name /Phone of those who have access to home:
Landlord and Phone (If Applicable):
Cleaning Service Day(s):	Alarm Code:

Instructions:

Meals and snacks:

Walk/Turnout schedule:

Allergies:

Medications:

Known Hiding places:

Favorite toys or games:

Additional Information:

Ex. Anyone Expected to Visit Home While Away?

Regular veterinarian (name and address): Information needed in order to obtain previous medical records if emergency occurs.	Phone:
Emergency veterinary clinic (name and address): Hospital where pet will receive emergency medical attention.	Phone:
Nearest alternate emergency veterinary clinic/veterinarian will be sought if your vet is unable to see your pet or is unreachable.
Emergency Contact:	Phone:
We give Pony Nanny Animal Services permission to authorize emergency medical care (excluding euthanasia) for our pet(s) as deemed necessary by a veterinarian, and we will be responsible for full payment of such care upon return. Every effort will be made to contact you (and the emergency contact person above if you are unreachable) if an emergency situation occurs.
Pony Nanny Animal Services will not be liable for the injury, disappearance, death, or fines of any pet with unsupervised access to the outdoors. I agree to pay the charges accrued for the services provided as outlined in this agreement upon my arrival. Signature: Date: