1

Home Buddies Dog Walking & Pet Sitting Thank you for your interest in Home Buddies! Safety is our first priority. In order to keep your dogs as safe as possible, we need the following information in addition to that you have entered in Power Pet Sitter. Has/have your dog(s) had any unpleasant situations with any neighbors or neighbor’s pets? __ Yes __ No. Information on situation: ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Are any of your dogs more dominant than most other dogs? __ Yes __ No If so, please describe and tell us how you manage it. ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Are there any unsafe situations in your home, yard or neighborhood that we should make sure to avoid? _ Yes __ No Details: ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Have any of the dog or dogs we will be caring for showed their teeth or behaved with hostility toward another dog or person? _ Yes __ No If so, please describe so we can avoid similar situations. ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

2

Have any of the dog or dogs we will be caring bitten another dog or person? _ Yes __ No If so, please describe so we can avoid similar situations. ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Have you listed the most current vet in PPS? _ Yes __ No Vet you now use: _________________ Are all of the pets we are caring for up-to-date on the rabies vaccination? _ Yes __ No ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Is there anything other info that can help us keep your pets safe and provide the best care possible? ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ The information provided above is completely accurate and no relevant information has been omitted. _______________________________ Printed Name _______________________________ ________________ Signature Date