Wag Away, LLC
Email: WagAway80446@gmail.com - Phone: 970-531-3521
Website: Wagaway80446.com
Client’s Name:
Cell:
Email:
Mailing Address:
Emergency Contact: ___________________________________ Phone:________________________
Neighbor: ______________________________________________ Phone: _________________________
How did you hear about WA?__________________________
Duration: Dates: Times:_____________
Veterinarian: Name/Phone: __________________________________________________
Pets:
Name: Female/Male Age: Species/Color:
Spayed/Neutered? Y/N Vaccines are up to date?Y/N Any history of biting?
Medication: Y/N
Feeding Instructions: Mediation Instructions:
Name: Female/Male Age: Species/Color:
Spayed/Neutered? Y/N Vaccines are up to date? Y/N Any history of biting? Y/N Medication: Y/N Feeding Instructions: Mediation Instructions:
1
Wag Away, LLC - Pet Profile
Email: WagAway80446@gmail.com - Phone: 970-531-3521
Website: Wagaway80446.com
Other services you may like:
Get Mail/paper: Y/N Water plants: Y/N Trash: Y/ N Windows open/closed: Y/N
Alter inside lights: Y/N Porch light on at night: Y/N Music/TV: Y/N
May we use your bathroom: Y/N
Got Front door Key: Y/N Code: _____________
Total due BEFORE service can be completed and put on WA’s calendar.
Total: $
Client’s Signature Date:
Owner/Agent, WA,LLC Signature: Lucinda Elicker Date:
Notes:
Fears? _________________________________________________
Location of towel for Mud/rain: ________________________________________________
Location of bowls:_____________ Extra food:__________ Treats:_____________
Location of leashes: _____________ Poop bags: ____________ Toys:_______________
Cleaning supplies for accidents: ______________________________________________
2
Pet Profile
Copyright © 2022 Wag Away, Pet Services - All Rights Reserved.
Powered by GoDaddy