Service Enquiry Form | Gee Whizz Walkies

Name *

Home Address *

Email address *

Contact Number *

Emergency Contact details other than in same household *

Service required *

Home Boarding
Pet Check-Ins
Dog Walking

Date From and To Service Required *

Is your pet/s a *

Dog
Cat
Rabbit
Guinea pig
Other

What are your pet(s) name(s)? *

Vet Details: Address and Phone Number *

Please state: Breed, gender, age and colour of pet(s)?

Is your dog microchipped? (Please state microchip number)

Is your dog up to date with vaccinations and Kennel Cough (Bordetella)? *

Vaccinations Yes
Vaccinations No
Kennel Cough Yes
Kennel Cough No

Is your dog neutered/spayed?

Yes
No

Is/are your dog/s cat friendly? (I have resident cats) *

Yes
No
Sometimes

Please explain your dogs/pets behaviour with recall, with other dogs, cats, humans, at home, and with livestock. *

Has your dog reacted negatively to any of the following? *

Noises
Actions
Objects
Types of dogs
Types of people
None of the above

If yes please briefly explain *

Has your dog shown aggression to a person or bitten them? If yes please briefly explain the circumstances. *

How does your dog travel? e.g Travel sick *

Will your dog travel/sleep in a crate?

Does your dog interact well with other dogs? *

Yes
No
Sometimes

What types of walks does your dog enjoy?

Ball play
Shore
Forest
Fell
Any of the above

Do you give permission for your dog to be off lead? *

Yes
No

Please state any health conditions, medication and dosage, dietary requirements relating to health. *

Do you give permission for photos to be shared on social media? *

Yes
No

Disclaimer and Waiver of Liability: The information I have given in this application is true, correct and complete to the best of my knowledge. I have and agree to abide by the Terms and Conditions for services received from Gee Whizz Walkies. *

I hereby in indemnify Gee Whizz Walkies against liability of any kind whatsoever arising from my dog(s) or pet(s) participation in services offered by Gee Whizz Walkies. *

I Agree
I Disagree

Key Holder Disclaimer and Waiver of Liability: The information I have given in this application is true, correct and complete to the best of my knowledge. I have read and agree to abide by the Terms and Conditions for services received from Gee Whizz Walk *

I understand that this form acts as permission to hold keys to my property, which I have provided willingly. I hereby indemnify Gee Whizz Walkies against liability of any kind whatsoever arising from damage or loss of property. *

I Agree
I Disagree

I agree that payments for services will be paid 7 days before commencement of service. *

Please tick to accept Terms and Conditions. *

I Agree
I Disagree

Full name and date to accept all of the above. *