Agreement for Services

Please complete the following form which must be kept on file in order to provide you with the requested services. You may complete this form and leave with payment and directions for pet feeding and care.

This agreement gives John Santorelli permission to enter my home at the address listed for the purposes of pet and/or house sitting until such time when either party decides to cease this arrangement. Additionally, in the event of any medical condition or emergency, client gives permission for John Santorelli, at his discretion, to take my pet(s), including outside pets that we have been instructed to feed and/or care for, to the vet listed below (or if that vet is closed, you authorize us to take your pet(s) to a veterinary emergency facility) and client will be responsible for all veterinary charges arising from such action. Additionally, you agree to pay me my prescribed rate for any extra time AND for extra visits to your home due to any sort of emergency with your home or pets while you are away and/or flight delays, etc that would require me to care for your pets longer than our previously agreed on time frame. Additionally, you acknowledge receipt and understanding of our policies as listed on the rate card and have filled out the medical form describing medical history, medications & the times and dosages to which we are expected to administer in addition to food and water.

I understand this agreement only needs to be signed once and will be kept on file and a typed name in the signature box is the same as a signature by hand and both are legal signatures. I have also read and fully understand all polices set forth on the Rate Card & Policies page.

Name:
Email:
Phone:
Street Address:
City:
FL
Emergency Contact:

( in case I am unable to reach you for anything important )
Security Code:
Alarm Company Codeword:

( in case alarm inadvertantly goes off )
Key Location:

( in case I don't have a copy on file )
Vet Contact Information:

( In case of emergency, include name and phone )
Questions / Comments / Concerns / Special Instructions:

Signature:

Date: Sunday, 28-May-2017 11:19:39 PDT